Pregnancy in the forties

The number of women who have a child after 40 years has grown 30 times over the last 40 years. Pregnancy after 40 is difficult and complications are more frequent.

Why is to more difficult to achieve a pregnancy after 40 years old?

Ovulation disorders are part of the most common causes of infertility in women. At the age of 40, ovulation may not always occur and the quality of the egg may be poor. The probability of conception in a woman is 25% per cycle at the age of 25, 12% at the age of 35 and 6% at the age of 40 years.

Should we seek advice before trying for a pregnancy after 40 years old?

Of course. Consulting your gynecologist offers a overall assessment of your health condition. If you have diabetes, or hypertension, this will help you stabilize the problem before you start a pregnancy. If you already had complications during a previous pregnancy such as a preterm delivery, your overall health assessment can find solutions to avoid repeating similar problems.

CVS or amniocentesis are done systematically?

Today we have the possibility to carry out the non-invasive control of chromosomal abnormalities called NIPT. This is a screening test (not a diagnostic) of the most frequent chromosomal abnormalities of the fetus. It is done by simply taking blood from the mother and therefore there is no risk of fetal abortion. This examination is accompanied by an ultrasound and detailed counseling on its possibilities and limitations.It does not replace invasive methods (eg trophoblast, amniocentesis), but it determines the likelihood of chromosomal abnormalities with greater precision than the cervical translucency test. Samples are sent to certified centers for their analysis.

Basic knowledge

The risk of having a baby suffering from trisomy 21 is 1 in 100 at the age of 40 (compared with 1 in 2,000 at the age of 25).

The vast majority of these pregnancies evolve quite naturally when monitored adequately. The first quarter is critical, because during most of the time, most automatic miscarriages happen. Their frequency exceeds 20% for women 40 years (compared with about 10% at the age of 25). The causes are mostly chromosomal.

The most common complication of end of pregnancy is gestational diabetes, particularly in overweight women. Insulin, the hormone that allows sugar to penetrate into the cells of the body, is no longer able to function normally. The sugar is therefore circulating at high blood levels, and the baby grows too much. When diabetes is diagnosed, a severe diet is given to the pregnant woman and, if necessary, medications are needed

As for preeclampsia (checked during a monthly visit to the doctor), which may be associated with the presence of proteins in the urine, at the age of 40 it is two to three times more common. Sometimes these symptoms are accompanied by a delay in fetal development. These pathologies may lead the doctor to a decision on premature labor

Cesarean section is more common after the age of 40.

Post-partum hemorragy is also more common after the age of 40.

Therefore these pregnancies hide more risks and could be described as a high risk pregnancy that needs follow-up by a specially trained gynecologist. Generally, most of these times pregnancies also progress naturally, and the woman who wants to become pregnant should not hesitate.The gynecologist will try with careful and detailed monitoring to eliminate or prevent any dangers in time, helping the pregnant woman get safely at the end of her pregnancy.