A 43-year-old woman can get pregnant, but the journey involves unique biological challenges and necessitates a clear understanding of the medical realities. While it is possible to conceive and carry a pregnancy to term at this age, the probability is significantly lower than in earlier reproductive years. Success hinges heavily on individual health and the condition of the remaining egg supply. Given the steep decline in fertility markers, seeking expert guidance from a reproductive endocrinologist is a prudent first step for any woman pursuing pregnancy at age 43.
Natural Conception Rates at Age 43
The chance of natural conception declines dramatically after age 40, reflecting reproductive aging. For women over 40, the probability of becoming pregnant in any single menstrual cycle is estimated to be less than 5%, a sharp contrast to the 20-25% monthly chance for women in their mid-twenties.
While some women in their early forties may achieve pregnancy within a year, the statistical likelihood is low for a woman aged 43. By this age, the cumulative chance of conceiving naturally is greatly reduced, and for most women over 45, natural conception is unlikely.
The Role of Ovarian Reserve and Egg Quality
The primary biological factors driving the reduced conception rate are diminishing ovarian reserve and declining egg quality. Ovarian reserve refers to the quantity of eggs remaining in the ovaries, which decreases steadily until menopause. Anti-Müllerian Hormone (AMH) is a blood marker reflecting this quantity, with levels typically falling below 1.0 nanogram per milliliter (ng/mL) in women over 40, indicating a diminished reserve.
Follicle-Stimulating Hormone (FSH) is often elevated in older women because the brain must release higher amounts to stimulate the aging ovaries. FSH levels exceeding 12 mIU/mL, measured early in the menstrual cycle, often signal a low ovarian reserve. While these markers reflect quantity, the more impactful factor is egg quality, which relates to the genetic health of the eggs.
The proportion of eggs with the correct number of chromosomes, known as euploidy, declines significantly with age. By age 43, the majority of eggs retrieved may be chromosomally abnormal, or aneuploid. This high rate of aneuploidy is the main reason for the increased risk of miscarriage and the low live birth rate observed in this age group.
Increased Health Risks for Mother and Fetus
Pregnancy at age 43 is associated with a higher incidence of complications for both the mother and the developing fetus. These risks necessitate closer monitoring throughout the gestation period.
Risks to the Mother
Women aged 43 face an elevated risk for certain medical conditions during pregnancy compared to younger women. The chance of developing gestational diabetes and hypertensive disorders like preeclampsia is notably higher.
Rates of Cesarean section delivery are also considerably higher for women in this age group. Furthermore, the likelihood of pregnancy loss, including miscarriage and stillbirth, rises with advancing maternal age. These increased maternal risks are often managed with specialized care from a maternal-fetal medicine specialist.
Risks to the Fetus
The advancing age of the eggs directly contributes to a higher risk of chromosomal abnormalities in the fetus. The chance of the baby having a condition like Down syndrome is substantially elevated at age 43. Genetic screening and diagnostic testing are routinely offered to assess this risk.
Fetal growth and timing of delivery are also points of concern. There is an increased incidence of preterm birth (before 37 weeks of gestation) and low birth weight. Close monitoring of fetal development and well-being through regular ultrasounds is a standard part of prenatal care.
Fertility Treatments and Recommended Testing
For a woman aged 43 pursuing pregnancy, the path often involves a comprehensive fertility workup and assisted reproductive technology. Recommended preliminary testing includes blood tests for AMH and FSH to assess ovarian reserve. These hormonal measurements, along with an Antral Follicle Count (AFC) determined via transvaginal ultrasound, provide a clearer picture of the remaining egg supply.
If fertility treatment is pursued, success rates for In Vitro Fertilization (IVF) using the woman’s own eggs are low, with live birth rates per cycle hovering around 5% for women aged 43-44. Using a donor egg from a younger woman dramatically improves the odds of a live birth to over 30-35% per cycle. This marked difference highlights that the age of the egg, rather than the age of the uterus, is the predominant factor in successful implantation and healthy pregnancy.