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Trying to Conceive Over 40? Here's what you need to know

Trying for a baby in your late 30's or over 40 is not uncommon, and with more and more couples choosing to start or continue their families later in life the births at ages 40+ are increasing more than ever before.


You've probably heard it all before that our fertility naturally declines from our late 30's onwards, but I still meet many people who haven't really been informed of the challenges that may arise with this. The purpose of this article is not to make you feel even more overwhelmed or pressured to begin trying for a baby, but instead provide you with as much knowledge as possible so that you can make informed decisions on beginning or growing your family!



So why does age have such an impact on fertility?


I mention miscarriage in this article- if you need support then please consider contacting the pink elephant support network.


The probability of natural conception reduces from about 25% each month in our mid 20's to just 5% by age 40. But why?


One of the biggest contributing reasons is that both egg health, and egg quantity reduce over time. Unfortunately unlike sperm which gets a reset every 3 months, eggs are exposed to everything that we are exposed to across our whole lives. The late nights drinking in our 20's, terrible diets we've embarked on, holiday drinks and eating, smoking and other substances- while a normal part of life for many, can impact on our egg quality over time.


It's also important to note that 20% of all human eggs have an incorrect number of chromosomes- either not enough or too many. This can mean that an embryo resulting from the egg is affected by a genetic disorder or isn't viable enough to progress into a healthy pregnancy and baby. As we get older the rates of these abnormal eggs increases which sadly increases the risk of miscarriage as well. There are some diet and lifestyle factors which we can focus on to help support egg quality and aid in reducing our chances of genetic abnormalities- which I will talk more on soon!


The total number of eggs that we have naturally decreases over time and the decline speeds up as we approach our 40's. An AMH (Anti-Mullerian Hormone) test can tell us our egg count, but remember this just tells us quantity not quality! The genetics and health of our eggs CAN be worked on which ultimately is more important when it comes to falling pregnant.


The good news is that there are steps that we can work on to improve our fertility.


  1. Don't delay seeking help from a fertility specialist


For women over 35 who have been trying for a baby for 6 months, it's recommended to reach out to a fertility specialist for support. It's also important to seek advice if you are experiencing painful, irregular, or heavy periods, or any significant changes to your cycle that you feel aren't normal for you. Getting help early can make all the difference when it comes to falling pregnant.


  1. Get some preconception testing done


Always get your preconception testing done even if this isn't your first baby. This can save so much time by identifying easy-to-fix problems or identify any significant barriers to conception. Both women and men should be having preconception testing (male health is 50% of the picture too!). Your GP should be more than willing to help you with this process.


  1. If you aren't already- start tracking!


Get as familiar as you can with your menstrual cycle. Get to know the different phases of your cycle (follicular and luteal), and the signs of ovulation. Begin tracking all of your symptoms, twinges, cramps, cervical discharge, spotting- everything! This knowledge helps you to time sex more effectively and also helps you later on if you seek support and advice. The more data the better!


  1. Once you know your fertile window- make sure you have sex!


So many couples just aren't having enough sex to increase their chances of falling pregnant. The best outcomes are seen with intercourse every second day throughout your fertile window. There is little statistical difference seen with those who try every day (only 4% increase in conception rates), so every second day should be sufficient. This also emphasises the importance of knowing when you are ovulating and being familiar with your fertile window.


  1. Focus on what you can control


It can be easy to worry about non-modifiable factors such as age, genetics, medical history, etc. However these aren't modifiable and we simply can't turn back the clock!


Focus on what you can control- your diet, exercise, stress levels, sleep, environment, endocrine disrupting chemicals, smoking, drug use. By focusing on what you can change you are able to take the most effective steps to improve your chances of pregnancy.


Of course there are specific conditions such as PCOS, Endometriosis, Thyroid conditions, Auto-immune conditions, Diabetes, Coeliac Disease, and Insulin Resistance which will require personalised diet and lifestyle advice when it comes to fertility. Make sure to book a consultation with me for your own tailored plan.


Here are a few tips for you to consider if trying for a baby:


1. Take a Prenatal Vitamin Daily


This one is important! So often people are taking just a standard dose of prescribed folic acid and iodine from the GP which in most cases just doesn't cut the mustard when it comes to meeting your nutritional needs. It's important that your prenatal vitamin has folic acid or folate (or both) and iodine. Also consider if you may need more folic acid (BMI >30, malabsorption conditions, etc.) and think about adding omega-3 into the mix as well.


Folate and omega-3 are significant players when it comes to trying to conceive and supplementation has been showing to improve your chances of conceiving (Gaskins & Chavarro, 2018).


2. Consider CoQ10 for Egg Health


Antioxidants are crucial and coQ10 is a well studied option linked to better embryo quality, especially for those over 35. It’s crucial to get the right dosage and form of CoQ10 for you, so ensure you consult with your fertility dietitian before adding it to your routine.


3. Antioxidant intake


There are additional supplements that may be beneficial such as NAD+ or specifics depending on your medical history, but it's also important to increase the antioxidants in your diet as much as you can too. Focus on this as a baseline starting point then add the necessary supplements on top for the ultimate increase in fertility.


Always discuss supplements with a fertility specialise dietitian before beginning anything new as not all are created equal and it's important that you take exactly what you need in the correct dose to see the best possible benefits.


If you would like a plan formulated specifically for you complete with meals, snacks, and a fertility specific supplement regimen then book a consultation. We can get your plan sorted and out to you within 48 hours to save you months of trying to work it all out on your own and give you the confidence that you are doing everything that you can to increase your chances of pregnancy.


4. Boost your Seafood Intake


Couples that consume more seafood boost their ability to conceive by about 61% (Gaskins, Sundaram, Buck Louis, & Chavarro, 2018). Aim to include seafood in your diet at least twice a week, prioritising oily fish species like salmon, ocean trout, sardines and anchovies.


5. Minimise Alcohol


The ideal scenario is total elimination as the truth is that eggs and sperm just don't love alcohol. Even just two standard drinks each week has been associated with a higher risk of miscarriage and complications.


  1. Reduce your exposure to endocrine disrupting chemicals:


These are found in items we use every day like receipts, food containers, drink bottles, cleaning products, beauty products, and so much more. The problem is that chemicals like BPA, phthalates, and dioxins can mimic natural hormones, particularly estrogen, which can disrupt menstrual cycles and negatively affect egg health. Your best bet is to identify your biggest exposures and minimise these as much as possible.


It is possible to conceive in your 40's, despite potentially being more challenging and seeking early support is important. Get a trusted GP on board, work with a fertility dietitian for nutrition support, and don't go it alone if you have already tried for 6 months with no success.


If you want to feel confident when trying for a baby in your 40's then make sure to schedule an appointment where we deep-dive into your nutritional needs and create a personalised fertility and supplement plan just for you.


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