As women, we hear a lot about the difficulty of getting pregnant as we age, but staying pregnant can often be the bigger challenge, especially as our fertility begins to wane.
The risk of miscarriage rises as a woman ages, with a dramatic rise starting after age 37, with the steepest increase occurring after age 40. By age 45, less than 20% of all recognized pregnancies are viable.
The man’s age matters too. Having a partner over the age of 40 significantly raises the chances of a miscarriage.
Over half of miscarriages are caused by genetic abnormalities. As women age, chromosomal defects in their eggs become increasingly common. On average, a woman in her early 20s will have chromosomal abnormalities in about 17% of her eggs; this percentage jumps to nearly 80% by a woman’s early 40s. And as men age, chromosomal defects and point mutations–changes to a single nucleotide in their DNA–become increasingly common.
How The Chances of Miscarriage Vary By Age Continue reading Age and the Risk of Miscarriage
Trying to figure out your chances of miscarrying? Sadly, you are going to have a hard time finding good information.
Many websites claim to tell you your risk of miscarriage, citing statistics that look like these:
But problems abound with their numbers.
Problem 1: These sites rarely provide their sources, so you cannot tell whether their information is reliable.
Problem 2: These sites do not breakdown miscarriage risk by other known risk factors, like the mother’s age.
Problem 3: Nearly all these sites derive their statistics from just two small studies, one which tracked 222 women from conception through just the first 6 weeks of pregnancy, and another which tracked 697 pregnancies, but only after a fetal heartbeat had been detected–a key point, because heartbeat detection dramatically lowers the chances of a miscarriage.
The lack of good information frustrated me when I was pregnant, and I bet it frustrates you too. So I have compiled a summary of the best research on risk of miscarriage. Where possible, I break down the risk by…
Edit: I also have a new post on how morning sickness signals a lower risk.
Continue reading Lies, Damned Lies, and Miscarriage Statistics
A few months back, a friend asked that I write about egg freezing:
“As a single woman in my mid-30s who has always been a strong maybe on kids (with preference for yes with right partner/financial circumstances), I’m now in a place where I feel like I need to start planning for either children and partner or freezing my eggs or SOMETHING before the options run out in the next few years… But most people online seem to be writing personal horror stories with multiple IVF fails.”
Many women face a similar quandary, wondering if they should freezing their eggs before it’s too late. Here’s what you need to know about egg freezing to make an informed decision.
Continue reading How Egg Freezing Success Rates Change with Age
Several years ago, before I was married or had even begun dating my husband-to-be, I was chatting with a reproductive endocrinologist about when I needed to worry about my fertility going into decline. I was about to turn 30. Should I be worried? And how many quality reproductive years did I have left?
She told me most women were fine at 30 or 35. At her clinic, she said, she rarely saw women with problems related to “advanced ovarian age” before they turned 37 or 38.
I was surprised, to say the least. Like so many women, I had heard ad nauseam about “getting pregnant after 35.”
Despite all the chatter, I was not actually clear on why 35 was an important cutoff. Was it because getting pregnant was more difficult after 35? Or staying pregnant became challenging after 35? Or was that the age when the risk of chromosomal abnormalities like Down’s syndrome rose dramatically?
It turns out that none of these reasons are correct. Because in fact there is no reason; age 35 is not actually a cliff. It is not even a sharp bend in the curve, a point at which birth rates go into a steep decline. Those sharp bends come later, after 37, and again after 40.
So why has age 35 been etched into our consciousness? Continue reading The Fertility Cliff at Age 35 is a Myth
One of my former colleagues became pregnant her first shot out of the barn, the first month off the pill. Her story would hardly be noteworthy, except that she was 41 at the time.
She wanted to tell other women about her experience, she confided to me. She saw it as a sign that women can have children after age 40.
I simply nodded in response, while I privately wondered if she had not just been very lucky.
But–and this is key–how lucky?
Having a baby in your 30s and early 40s–and earlier, for that matter–is always a chance event. There will be outliers. Some women will give birth naturally at 44. Some women will suffer from early menopause at age 30. But outliers tells us little about the norm.
Anyone who wants to play the conception game, especially if they are postponing childbearing, needs to put anecdotes aside and try to grasp the actual odds. Here’s what every woman needs to know:
Continue reading Fertility in Your 30s and 40s: 7 Things You Need to Know