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Trying for pregnancy after 35

3-minute read

Many women try for a baby after 35. Almost one in four (24%) pregnant Australian women are aged 35 and over. But there are risks and challenges you need to know about.

If you've been trying to get pregnant for six months or more, you should see a doctor to discuss your fertility.

It can be harder to get pregnant than when you were younger. You're at your most fertile in your early 20s. In general, fertility starts to decline faster after the age of 30, and declines more significantly after the age of 35.

The older you are, and your partner is, the more likely it is to take a long time to conceive.

Why does your fertility decline?

At birth your ovaries have all the eggs you will ever have — between 1 million and 2 million. By puberty, half of them will be gone. As you get older, the number of eggs continues to reduce. Also, your eggs age as you do, and older eggs don’t fertilise as easily.

But still, you only need one.

Improving your chances of becoming pregnant

You’ll have a better chance of getting pregnant if you understand your menstrual cycle. The average cycle is 28 days, but it can vary from anywhere between 20 to 40 days for some women.

If your cycle is regular, then you can know that you probably ovulate 2 weeks before the start of your next cycle. So you can work from that and work out the best time to have sex.

Also, both you and your partner should be as healthy as you can be. Apart from anything else, this really will help your chances of getting pregnant. You can both:

When should you ask for help?

If you’re over 35 and you’ve been trying to get pregnant for six months or more, you should see a doctor.

For women under 35, the usual advice is to try for a year first, unless you know you have issues like endometriosis or other conditions that can affect your fertility.

Treatments

There are many options available for women who are having trouble getting pregnant. The treatment depends on the cause, so first you'd want to look into why there's a problem.

First, you and your partner would have a number of fertility tests, which might include sperm tests, checks for sexually transmitted infections, and possibly an ultrasound.

Depending on the results, your doctor might suggest treatments such as:

  • hormone therapy
  • IVF and variations such as intracytoplasmic sperm injection (ICSI)
  • artificial insemination

These treatments can all work. None is guaranteed.

For example, most women have a 33% chance of taking home a baby after one IVF cycle, and 54% after 8 cycles. But for women aged 40 to 44, this decreases to 11% after one cycle and about 38% after 8 cycles.

If you get pregnant?

If you are over 35 and have become pregnant, it’s important that you get good antenatal care, as there are a few things that you need to watch out for, such as gestational diabetes, high blood pressure and the chance of twins.

You might also want to talk to your doctor or midwife about genetic counselling and tests like amniocentesis and chorionic villus sampling.

More information

For more information and advice, call Pregnancy, Birth and Baby on 1800 882 436.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: February 2020


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Freezing sperm or testicular tissue There are two methods used to preserve fertility in men. Sperm freezing You produce a semen or sperm sample through masturbation in a private room in the fertility clinic. A lubricant is not used as this can damage the sperm. Small amounts of sperm are placed in straws which are carefully labelled. These straws are then frozen and stored in a tank with liquid nitrogen at the clinic. If possible, several samples are stored to make sure there is enough sperm to conceive one or several children. While the freezing process usually affects the quality of the sperm, in most cases plenty of good quality sperm survive. This method is also used for men before they begin cancer treatment or gender transitioning. Once you are ready to try for a baby, you can undergo fertility treatments such as IVF or artificial insemination with thawed sperm. Testicular biopsy Sometimes it is not possible to get a good sample of sperm through masturbation. In such cases your doctor will talk to you about testicular biopsy in which sperm are harvested directly from the testes. Cancer and fertility Some cancer treatments can affect your fertility. If you have been diagnosed with cancer, fertility preservation is an important consideration.  Depending on the type of cancer and its treatment, your fertility may recover, but the treatment may also cause temporary or permanent infertility. Cancer and its treatment can affect: ovarian function and the production of sperm the ability to carry a pregnancy the ability to have sexual intercourse emotions and feelings, which can impact on relationships. Some factors may reduce fertility including: The type of cancer. Testicular cancer or Hodgkin’s Lymphoma can result in poor sperm count or quality. The type of treatment. Radiation treatment to the pelvis is more likely to lead to infertility than radiation to other parts of the body. Chemotherapy using alkylating agents such as cyclophosphomide is more likely to affect fertility than treatment with other agents. The dosage. Higher doses of chemotherapy or radiotherapy used for a longer period of time are more likely to affect fertility than lower doses used for a shorter time. In general, the older a woman is at the time of diagnosis, the fewer eggs she will have, the poorer their quality will be, and the more vulnerable her ovaries will be to the effects of chemotherapy. The good news is that there are a number of fertility preservation options for both men and women with cancer to provide you with a good chance of having a baby in the future. Following a diagnosis When you are diagnosed with cancer everything can seem overwhelming. For most, focussing on getting through treatment takes priority. However, it is important that you (and your partner, if any) speak with your doctor (oncologist or haematologist) about how the cancer and treatment can affect your fertility and ability to have a child in the future. Your doctor will be able to take you through the advantages and disadvantages of different treatment options. They can also refer you to a fertility specialist for fertility preservation (both before and after treatment) and the use of contraception to avoid unwanted pregnancy.  What are my options? Advances in technology mean that as time progresses, more fertility preservation options become available, each with advantages and disadvantages. For men, options include sperm freezing or gonadal shielding (for radiation therapy). For women, options include egg freezing, embryo freezing, gonadal shielding or ovarian transposition (for radiation therapy). After treatment you can have a fertility assessment to see if your fertility has been affected. If not, you can try to conceive naturally. If your fertility has been affected, your fertility specialist will discuss the best option to use your stored eggs, sperms or embryos based on your personal circumstances. This may include using IVF, intrauterine insemination, or home insemination. There are also options if you are unable to conceive naturally and did not have the opportunity to preserve your fertility before cancer treatment. These include: donor conception (donated eggs, sperm, or embryos) surrogacy adoption/permanent care Options for transgender & gender diverse people  Fertility preservation is an option for transgender and gender diverse people to have children in the future.  There can be many things to consider when affirming your gender, including whether or not to pursue the option of medical transition. With so much to decide, taking a moment to think about whether you might like to have a family in the future, and understanding what you need to do in order to maximise your fertility options, can sometimes be forgotten in the process. It is important to consult a fertility specialist before medical transition begins to discuss your options for fertility preservation specific to your circumstances. Your fertility specialist will be able to assist you before, during and after medical transition. For trans men (assigned female at birth) Using testosterone will create significant changes to your body, including ceasing your egg production and menstrual cycle. Fertility may be restored if testosterone is ceased, but that cannot be guaranteed. You can take steps to preserve your fertility before beginning hormone treatment. Other reproductive options also exist after transition. Before transition Traditional conception - Choosing to have a child (or children) by having sex or via insemination before undergoing hormone therapy may be an option for some people. Others may not want to proceed in this way for a variety of reasons, including the potential delay to medical transition. Egg freezing - You may preserve your fertility via egg freezing before hormonal therapy begins. This would involve having treatment to develop multiple eggs which would be collected and stored for later use. It is similar to the first part of an IVF cycle in which injections are given and requires internal ultrasounds. Side effects from the medication may be experienced. It is important to keep in mind that egg freezing does not guarantee a successful pregnancy when you are eventually ready to start a family. Fertility treatment - Another option is to create embryos using IVF. Sperm, either from a male partner or a donor will be needed to create an embryo using your eggs. Your embryos will be frozen for later use. If you are partnered with a woman, your partner will be able to carry the pregnancy. Surrogacy is also an option if you are partnered with a man or unable to carry the pregnancy. After transition If you are single or partnered with a man, and have preserved your fertility you could have a child using your stored eggs or embryos with the assistance of a surrogate. You may be able to have a baby if you have not stored eggs or embryos. If you have not had surgery affecting your reproductive organs, it may be possible to cease hormone treatment, begin to produce eggs again, and try to conceive. This approach needs to be carefully managed medically. It may also create additional emotional challenges for you. It is not known whether the health of the child born may be affected by the hormone treatment. Seek additional support and guidance from your treating doctor and counsellor or therapist before and during this process. If you are partnered with a woman you may consider using a sperm donor.  Surrogacy is also an option. For trans women (assigned male at birth) Using oestrogen (and antiandrogen) will, over time, cease the production of sperm and make it difficult (if not impossible) to achieve an erection or ejaculation. It is unlikely that fertility will be restored after a significant period of time on hormones. It is not possible to estimate how long it takes for fertility to be lost. However, reproductive options after transition also exist. Before transition Traditional conception - For those partnered with a woman, conception via intercourse or insemination is the simplest and least expensive method for starting a family although it may be emotionally challenging. Sperm freezing - Sperm can be frozen before beginning hormone therapy. This is usually done via masturbation in a private room at a fertility clinic, although it may be possible to bring the sample from home. The sperm is then put in straws, carefully labelled, and frozen in liquid nitrogen. For those who are not able to produce a sample via masturbation it is possible to collect sperm via a testicular biopsy. Fertility treatment - For people who are single before transitioning or partnered with a man, building a family will require the use of a donor egg or embryo and a surrogate. People building a family this way will be able to do so before or after transition. After transition I have sperm stored - If you are in a relationship with a woman and stored your sperm before transitioning, the sperm can be thawed and used in an IVF or ICSI procedure.  If you are partnered with a man, you may either use your stored sperm or your partner’s sperm. You will also need the help of an egg or embryo donor and a surrogate. I don’t have sperm stored – It can be possible (if you have not had surgery affecting your reproductive organs) to cease hormone treatment and begin to produce sperm again. However, sperm production may not return. This approach needs to be carefully managed medically. It may also create additional emotional challenges for you. It is not known whether the health of the child born may be affected by the hormone treatment. It is suggested that you seek additional support and guidance from your treating doctor and counsellor/therapist before and during this process. If you are partnered with a man, surrogacy with the use of an egg or embryo donor is an option. If you are partnered with a woman you have the option of using donor sperm treatment. Ask both the doctor supervising your transition and a fertility specialist about your options.

Read more on Victorian Assisted Reproductive Treatment Authority website

Nutrition and supplements | Your Fertility

Women and men can improve the chances of a pregnancy and give their baby the best start in life by having a healthy diet, well before a baby is conceived

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