Pregnancy at 44 is possible, though less common than at younger ages. This question is common for many individuals considering starting or expanding their families later in life. Advancements in reproductive medicine and increased awareness of fertility options mean conception can occur, often requiring careful planning. This article explores fertility realities at this age, the likelihood of natural conception, available medical interventions, and health considerations for both mother and baby.
Biological Realities of Fertility at 44
A woman’s reproductive system changes significantly in her mid-40s. Women are born with all their eggs, and both the quantity and quality naturally decline over time. This decline accelerates around age 35, continuing into the 40s as women enter perimenopause. During this phase, hormonal fluctuations become more pronounced, and the ovaries gradually release less estrogen and progesterone.
The reduced quantity of eggs is known as diminished ovarian reserve, directly impacting fertility. Beyond quantity, the quality of the remaining eggs also decreases significantly. By age 44, approximately 90% of a woman’s eggs may have chromosomal abnormalities. This increases the risk of miscarriage and lowers the chance of successful conception.
Chances of Natural Conception
The likelihood of natural conception for a 44-year-old woman is considerably lower than for younger age groups. Fertility peaks in the late teens through the late 20s, declining steadily thereafter. For women aged 40-44, the chance of becoming pregnant in any given menstrual cycle drops to less than 5%.
If a woman aged 40-44 has regular, unprotected sex for a year, up to 20% may achieve pregnancy. This percentage includes all women within that age bracket, and the odds decrease with each passing year. The time it takes to conceive naturally also tends to be longer for this age group. If pregnancy occurs naturally at this age, there is a higher risk of miscarriage, with rates ranging from 33% to 50%.
Assisted Reproductive Options
For women aged 44 seeking to conceive, various medical interventions can increase their chances. In Vitro Fertilization (IVF) is often considered the most effective assisted reproductive technology for women over 40 using their own eggs. IVF success rates with a woman’s own eggs decline sharply with age. For women aged 44 and above, the live birth rate per IVF cycle can be as low as 1% to 2%. One study indicated a live birth rate of 3.6% per initiated IVF cycle for 44-year-olds using their own oocytes.
Given the significant decline in egg quality and quantity, egg donation becomes a more viable option. IVF with donor eggs utilizes eggs from younger, healthy donors, substantially increasing success rates. Success rates for IVF with donor eggs can range from 35% to over 50% for recipients in their 40s, with some clinics reporting up to 49% live birth rates for women aged 44-52. The age of the egg, not the uterus, is the primary factor affecting success with donor egg cycles.
Health Considerations for Mother and Baby
Pregnancy at age 44 carries increased health considerations for both mother and baby. For the mother, there is a higher risk of developing gestational diabetes, where high blood sugar levels develop during pregnancy. The risk of gestational diabetes for women aged 40-44 is more than double that of younger women. Preeclampsia, characterized by high blood pressure and organ damage, is also more common, affecting approximately 18% of pregnancies in women aged 35-44.
Women aged 44 also experience higher rates of cesarean sections, often due to increased pregnancy complications. For the baby, the increased risk of chromosomal abnormalities, such as Down syndrome, is a concern due to the older age of the mother’s eggs. For a 40-year-old woman, the risk of having a child with Down syndrome is approximately 1 in 100. There is also an increased risk of prematurity and low birth weight for babies born to older mothers. Preconception counseling is recommended to assess health and discuss potential risks. Early, comprehensive prenatal care is important for monitoring and managing these considerations throughout pregnancy.