Trying to conceive over 40 is not uncommon. More and more women are choosing to delay pregnancy for several reasons, in fact approximately 4.5% of Australian women are giving birth at ages 40+ and this percentage is increasing more than ever before (Australian Institute of Health and Welfare, 2024).
However, it’s important to understand that fertility rates naturally decline as we age, particularly from our late 30s onwards. We know you’ve probably heard it all before, but still, we encounter people who’ve never really contemplated the potential challenges of starting a family in their 4th decade.
Our goal is to not make you feel pressured about trying to conceive, but provide the facts so you can be armed with the knowledge to move forward on your path to grow your family!
The chances of conceiving naturally each month drop from about 25% in our mid-20s to just 5% by age 40 (American Society for Reproductive Medicine, 2012). I know, these numbers can be slightly scary, but it’s essential to approach this journey with healthy expectations and have a plan in place.
Just a brief heads up: Pregnancy loss is a topic discussed in this blog post. If you need support please seek the advice of your GP or reach out to The Pink Elephant Support Network.
Why Does Age Have Such a Big Impact on Female Fertility?
As women, we’re born with all the eggs we’ll ever have—no chance for a reset or do-over.
Throughout our lives, these eggs experience everything right along with us, from the late nights in our 20s drinking, experimenting with substances, smoking, or perhaps not always making the best diet or lifestyle choices. While these experiences are a typical part of life for many, it’s important to remember that our eggs don’t get a refresh button, like sperm do.
Additionally, approximately 20% of all human eggs are aneuploid (Jones, 2008), meaning they have an incorrect number of chromosomes—either too many or too few. This may mean that the a resulting embryo may be affected by a genetic disorder, or is not compatible with life.
As we get older, the number of aneuploid eggs rises, which sadly increases the risk of miscarriage. For women aged 35-39, the risk is around 35%, but it jumps to 51% between ages 40-44, and by 45, it’s as high as 93% (RACGP). Unfortunately, this is a natural part of the ageing process that we can’t significantly change or screen for. Although scientists are working on it!
On top of this, the total number of eggs we have naturally decreases over time, and this decline speeds up as we approach our 40s.
Unfortunately, there’s nothing we can do to stop it. However, we can measure our remaining egg count through an AMH (Anti-Mullerian Hormone) test—find out more about that here. But keep in mind, this number only tells us quantity, not quality. The genetics and health of our eggs, which are arguably even more important, are factors we can actually work on!
As a Fertility Dietitian, I know this reality can be tough to come to terms with. While we can’t turn back the clock, there are definitely steps we can take to enhance our chances of conceiving.
Trying to Conceive Over 40? Top Tips Before You Start
1. Get Some Pre-Conception Lab Work Done Through a GP
Even if this isn’t your first pregnancy, it’s still important to get pre-conception lab work done. This helps identify any potential barriers to conception and ensures you’re in the best possible health before trying to conceive. It’s highly encouraged, and GPs will be more than willing to help you with this process.
2. Know Your Timelines
If you’re experiencing issues like painful, irregular, or heavy periods, or if you have a medical history that could impact your fertility, it’s important to seek help from a fertility specialist sooner rather than later.
This is also crucial if you’ve experienced a pregnancy loss or are dealing with recurrent pregnancy loss. For women over 35, it’s generally recommended to seek assistance after trying to conceive for 6 months.
Don’t hesitate to reach out for support—timely intervention can make all the difference.
3. Know Your Menstrual Cycle
Take the time to get to know your menstrual cycle better.
Understanding the different phases—the follicular phase, luteal phase, and the signs of ovulation—can help you pinpoint your fertile window. This knowledge allows you to time intercourse more effectively.
4. Understand What You Can and Cannot Control
Non Modifiable Factors:
Age – sorry, no time machines here!
Conception Partner’s Age – if you have a male partner, his sperm health is a critical ingredient to your trying to conceive journey.
Family history
Genetics
Number of Aneuploid eggs
Medical History – such as endometriosis and other autoimmune conditions.
Rather than fixating on age, it’s more beneficial to focus on the modifiable factors that may make all the difference. By concentrating on these aspects, you’ll be taking the most effective steps to improve your chances of conception.
THE DIETOLOGIST
Top 10 Diet and Lifestyle Changes to Increase Chances of Conceiving When Over 40
Before we get into it, specific conditions such as PCOS, Endometriosis, Thyroid conditions, Auto-immune conditions, Diabetes, Coeliac Disease, Insulin Resistance will require personalised diet and lifestyle advice. Book a consultation with our team of experienced fertility dietitians for your own tailored plan.
Here are some foundational things to start thinking about when preparing for trying to conceive when age 40 and above. Remember, after 6 months of unassisted conception, you should seek further medical support from a fertility specialist.
1. Take a Prenatal Vitamin Daily
Make sure your prenatal multivitamin contains the right amount of folate or folic acid, as this is crucial for your health and the health of a future pregnancy.
Additionally, consider adding an omega-3 supplement to your routine. Both folate and omega-3s play important roles in enhancing fertility, and studies show that taking these supplements can improve your chances of conceiving (Gaskins & Chavarro, 2018)
NAD+ is a coenzyme vital for energy production, but its levels naturally decrease as we age (Covarrubias et al., 2021).
Restoring NAD+ through supplements might help slow or even reverse some of these effects.
Early evidence in mice shows an ovarian rejuvenation effect – human studies are underway! (Bertoldo et al., 2020).
This may be slightly experimental but is something worth considering and discussing with a fertility specialist.
As always make sure that you don’t start taking any supplements without personalised advice from a health practitioner in the fertility space.
You can book in with our team of experienced fertility dietitians who’ve formulated over 500 custom supplement plans for individuals and couples trying to conceive or navigating fertility treatments.
Eating a variety of colourful fruits and vegetables is crucial for maximising your antioxidant intake.
This helps protect your precious eggs during their sprint to ovulation, which takes about 90-120 days before conception.
Antioxidants play a key role in shielding your eggs from environmental damage, toxin exposure, alcohol, and other dietary factors. Paying attention to this 90-120 day window before conception is especially important for optimal egg health.
At the end of the day, our eggs don’t love alcohol. Some studies have found that as little as two standard drinks per week have been linked with an increased risk of pregnancy loss, which is already a higher risk in those aged 40 and above, as previously discussed.
7. Reduce Exposure to Endocrine Disrupting Chemicals (EDCS)
EDCs are found in a range of everyday items, from plastics and thermal receipts to food packaging, cleaning products, cosmetics, and hair care products. I know this list can feel overwhelming, but it’s important to be aware. Chemicals like BPA, phthalates, and dioxins can mimic natural hormones, particularly estrogen, which can disrupt menstrual cycles and negatively affect egg health.
For more insights on this topic, listen to our podcast episode with Lucy Lines, Embryologist & Fertility Educator on everyday toxin exposure and fertility health – promise it is not as woo-woo as it sounds!
8. Move Your Body in a way that you Enjoy!
Find a form of exercise that you genuinely enjoy and make it a regular part of your routine. The benefits of physical activity on both physical and mental health are well-established. For fertility, getting your blood flowing and managing stress through exercise can be very beneficial.
Just remember, it’s possible to overdo it, so if you have any concerns, seek guidance as needed.
This isn’t just important for overall health; it’s crucial for fertility as well. I understand that getting enough rest can be challenging, especially if it is not your first child and you have small children. Melatonin, is an important hormone for not only sleep but IVF outcomes too (Espino et al., 2019). Think about your current sleep routine and what you may be able to change to maximise how much uninterrupted sleep you are getting.
10. Manage Your Stress Levels in a Healthy way
Emotionally eating, over-exercising, and using alcohol as coping strategies for stress can significantly affect your fertility. While research on the direct impact of stress on fertility is still mixed—learn more here. It’s clear that these habits can have negative consequences.
Trying to conceive can be a stressful experience, so don’t hesitate to seek out support if you need it and find healthy ways to manage stress levels such as yoga, mindfulness, meditation and walking.
While trying to conceive in your 40s can no doubt be more challenging, seeking support early is crucial. It is important to build your support team from the start, including mental health professionals, nutrition support and linking with a trusted GP and fertility specialist after 6 months of trying without success.
Are you ready to feel confident about your diet and lifestyle when it comes to trying to conceive in your 40s? Hop on a Zoom consult with an Award-Winning Fertility Dietitian inside our Fertility Nutrition Intensive.
This 2-hour one-on-one session where we’ll create a personalised fertility and supplement plan just for you.
