Nowadays it is increasingly common to have a pregnancy at 40 years of age or after these. However, at this age it is more difficult to get pregnant and, in addition, pregnancy involves certain risks. Fortunately, some of these complications can be prevented thanks to advances in science. Would you like to know more?

In this article, we will tell you what are the most frequent complications associated with a pregnancy from 40 years old and what you can do to avoid them.

Is it difficult to achieve a pregnancy from 40 years old naturally?

Today’s lifestyle leads many women to delay motherhood until their 40s. One of the factors that most influence this decision is job stability, which in many cases is not reached until well into the 30s. For this reason, being a new mother around the quarantine is increasingly common.

Although it is important to understand that, although we take care of ourselves and our overall health and physical condition at that age is very good, even better than in previous stages of our life (many times we take care of ourselves more than in our twenties), it is inevitable that the body change with age. At age 40, the chances of achieving pregnancy naturally are only 5% each cycle. And after 45 they plummet to 1%. In the case of a natural pregnancy, the risk of miscarriage increases by 50%, and that of genetic abnormalities in the fetus is 1-12%.

Risks and complications in pregnancy at age 40

Pregnancy is a process that is accompanied by numerous physical changes and involves an overstrain for the woman’s body. Therefore, although complications can occur at any age, from the age of 40 the risk of various pathologies increases, among which are:

• Gestational diabetes, which can affect both the mother and the fetus.

• Preeclampsia (high blood pressure and high levels of protein in the urine).
• Placenta previa (placenta located in a lower position than normal) or abrupt (detachment of the placenta before delivery). Any of these problems make vaginal delivery difficult. In addition, starting at age 40, contractions may not be as effective, which also increases the likelihood of cesarean delivery.
• Increased risk of preterm birth.
• Recovery after delivery is slower, with a higher risk of complications.
• The baby is more likely to have chromosomal abnormalities such as Down syndrome.

We see that the risk of complications increases after 40. Therefore, if you want to get pregnant from this age, it is recommended that you have a complete check-up beforehand to rule out pathologies that may further complicate pregnancy. In addition, during pregnancy, it will be necessary that the check-ups include a more exhaustive medical control. 

These reviews will mainly control:

• Blood pressure and glucose level, to detect as soon as possible some of the possible complications such as gestational diabetes or pre-eclampsia.

• Presence of cardiac pathologies, which are more frequent at this age.

• Tests for breast cancer screening, the incidence of which increases at this stage of the woman’s life.

• Functioning of the thyroid, which participates in the metabolism of iodine, an essential microelement in the neuronal form of the fetus.

What is the reason for the increased risk and lower probability of pregnancy after 40 years?

Women are born with a certain number of follicles (approximately 1 million), which are the structures that contain the eggs. The quantity and quality of the ovules diminish as the years go by, and many of these follicles undergo degeneration, which is why the ovum does not mature. Men, on the other hand, continue to produce sperm throughout their lives.

At 40 years of age, the woman’s ovarian reserve is greatly diminished and, furthermore, the eggs that remain are normally of low quality, being frequent alterations in the number of chromosomes. If this occurs, when fertilized by the sperm, instead of forming an embryo with 46 chromosomes, the embryo may be missing or on a chromosome. This is what happens in Down syndrome, where there is an extra chromosome (three chromosomes 21 instead of the expected 2). The risk of Down syndrome increases exponentially in women from the age of 35, which implies a considerable risk at 40.

Alterations in the number of chromosomes in other chromosomes other than 21 can also occur, in most cases causes the pregnancy not to progress and a spontaneous abortion occurs. This is the reason why abortions are more common in pregnancies aged 40 and over.

The best reproductive age of women

The optimal reproductive age of women is around 20 years, and fertility begins to decline markedly after 35.

While at age 30 a healthy and fertile woman has a 20% chance of achieving a pregnancy in each cycle, at age 45 this probability is only 1%.

The loss of fertility usually occurs over the age of 45, before the beginning of menopause. However, according to data from the latest fertility survey of the National Institute of Statistics (INE), in 2018 79.2% of women in Spain between 25 and 29 years old had not yet had children.

Do the sperm lose quality?

The passage of time also affects the quality of sperm and for a long time it was thought that it was produced from the age of 60, but there are more and more articles that show that the quality of sperm decreases from the age of 40, observing a greater presence of alterations in DNA.

Techniques that help you get pregnant at 40

From the age of 40, it is important that health checks are exhaustive, both before planning the pregnancy and during it, to detect possible pathologies early.

Thanks to advances in science, it is possible to detect chromosomal abnormalities during pregnancy which, as we have explained, are more frequent at this age. On the other hand, in case a woman cannot get pregnant naturally, there are also options to achieve pregnancy. Next, we are going to see some of them.

Oocyte donation

This IVF technique uses donor eggs when the woman cannot achieve a pregnancy with her own eggs. 

Egg donation allows a greater probability of pregnancy in women over 40 years of age, with a lower risk of chromosomal alterations. However, in some cases, it can generate anxiety and doubts, since the woman must understand that this process does not transmit her genetic information.

Egg vitrification

This technique consists of freezing a woman’s ovules ideally during the second decade of her life, or at least before the age of 35. During the twenties is when the ovules present the highest quality, to be able to use them in the future when she wishes to become pregnant.

Preimplantation genetic screening (CGP)

Preimplantation genetic screening (PGC) is a technique that can be used in cases of in vitro fertilization when there is a medical indication. It consists of analyzing if there are chromosomal alterations, that is, it allows us to know if the genetic endowment of the embryo is adequate before it is implanted in the uterus. This test is indicated in cases of repeated abortions or when the maternal age is advanced and allows embryos to be implanted with their own eggs in which the presence of frequent chromosomal alterations has been ruled out.

As you can see, although complications are greater at this age, today science gives us tools unimaginable a few years ago, which make it possible to have a pregnancy at 40 years of age or older and prevent some of the associated risks.

How to detect genetic abnormalities in my baby if I am already pregnant?

If you are going to be a mother, no matter how old you are, you can count on non-invasive prenatal tests that analyze the risk of chromosomal abnormalities in the fetus, and that is carried out in a simple way with a sample of maternal blood.

From Veritas we offer you my prenatal, a non-invasive prenatal test that allows analysis of free fetal DNA to detect chromosomal abnormalities, with greater reliability than the commonly performed combined first-trimester screening. This greater reliability avoids in many cases the performance of unnecessary invasive procedures. In addition, with my prenatal you can request a more advanced analysis, so you will get more information about the health of the future newborn.

In short, my prenatal is a reliable, fast, and safe test, with which possible anomalies in the chromosomes of the future baby are studied, thus being able to carry the pregnancy with more peace of mind. If you want more information, do not hesitate, contact Veritas. We will be happy to answer your questions!