Geriatric Pregnancy (Advanced Maternal Age)

How does age affect fertility?

As you get older, your fertility declines, making it harder to get pregnant. You are born with a fixed number of eggs, which decreases with age. The quality of your eggs declines as well, and they are more likely to have chromosomal abnormalities.

A healthy woman who is under 30 has an approximately 85% chance of conceiving within 12 months. This falls to 75% by age 30, 66% by age 35 and 44% by age 40. By age 45, you are unlikely to get pregnant naturally. The chance of miscarriage also increases as you get older.

Women in their 30s and 40s are also more likely to have health conditions that can affect fertility, such as high blood pressure or diabetes.

Male fertility also tends to decline with age, but this decline is more gradual.

If you are 35 or older and have not become pregnant after six months of unprotected sex, talk to your OBGYN about an infertility evaluation. If you are over 40, you should see them before you start trying for a baby.

When should I talk to a doctor?

If you're 35 or older and planning to have a baby, it's important to talk to your OBGYN or healthcare provider before trying to conceive. They can help you create a personalized plan to optimize your health for pregnancy.

Once you get a positive pregnancy test, contact your doctor. Depending on your age, they may want to see you sooner and discuss prenatal screening and diagnostic tests, including:

• Low-dose aspirin and maternal serum screening: If you have risk factors for preeclampsia, your doctor may recommend a daily low-dose aspirin. You’ll also likely have screenings (between 15 and 18 weeks) to check for conditions like Down syndrome and spina bifida.
• Non-invasive prenatal testing (NIPT) and anatomy ultrasound: NIPT, which can be done as early as 10 weeks, screens for genetic conditions like Down syndrome and reveals your baby’s gender. Between 18 and 22 weeks, an ultrasound will check your baby’s growth and look for birth defects.
• Diagnostic testing: If screening shows a higher risk, your doctor may suggest chorionic villus sampling (CVS) or amniocentesis for clearer results on genetic conditions.
• Third-trimester growth scan and fetal surveillance: If you're 40 or older, your doctor may recommend a growth scan and additional monitoring between 32 and 36 weeks to check your baby’s health and reduce the risk of stillbirth.

Your doctor will provide guidance on which precautions and tests are right for you based on your personal health history and circumstances.

If you’re of advanced maternal age, know that things are much different than in past generations. With more resources and support than ever before, there are plenty of options available to help you have the best pregnancy experience possible.

How can I have a healthy pregnancy at 35 and older?

No matter your age, taking care of yourself before and during pregnancy can help you have a healthy baby. Here’s what you can do:

• Schedule a preconception appointment: Before trying to conceive, talk to your healthcare provider about your overall health, fertility concerns and lifestyle changes that can support a healthy pregnancy. They can also discuss ways to improve your chances of conception and explore options if you have trouble getting pregnant.
• Stay on top of prenatal care: Regular prenatal visits allow your provider to monitor your health and your baby’s development. Make sure to bring up any concerns or symptoms—early intervention can make a big difference.
• Eat well and take prenatal vitamins: A balanced diet rich in folic acid, calcium, iron and vitamin D supports your baby’s growth. A daily prenatal vitamin, ideally started a few months before pregnancy, helps fill any nutritional gaps.
• Gain weight wisely: Healthy weight gain benefits both you and your baby and makes postpartum recovery easier. Work with your provider to determine the right amount for you.
• Stay active: Regular exercise can ease pregnancy discomfort, boost energy and strengthen muscles needed for labor. Get your doctor’s approval before starting or continuing a workout routine, especially if you have any medical conditions.
• Avoid harmful substances: Stay away from alcohol, tobacco and recreational drugs. Always check with your provider before taking any medications or supplements.

By taking these steps, you can help ensure a healthy pregnancy and give your baby the best possible start.

Frequently asked questions