Getting pregnant over 40, risks, etc: who's got the facts and stats?

[motherinferior]

Lovely mate of mine has just taken up with lovely bloke (after EIGHT YEARS of singleness. Indeed of celibacy [shudder]). She is just pondering, as you do, the whys and wherefores of pregnancy at 41ish...Down's risk is up, right, but are other chromosomal abnormalities? And is there anything conclusive about fertility, apart from the fact it's all quite individual but does go down from the decade before we start menopause?

Oh go on, it'd be fab if she had a baby, she's had such a vile time for ages.

bumping this up for you, sadly cant answer your question but hopefully someone else can.

eight years of celibacy

after 8 yrs of celibacy, she probably won't see the light of day again till she's 45

nothing but non scientific waffle from me...

the woman i used to nanny for, had her children aged 39 and 40...no complications...a 'walk in the park'

I've just been skimming Birth over Thirty-Five by Sheila Kitzinger (currently my bedtime reading as pregnant at 38 - hurrah)! According to the author the risk of ALL chromosome abnormalities are:

Mothers Age Incidence (1 in ...)
25 527
30 476
35 204
40 73
45 23

The risk specifically of Downs syndrome according to the author is:

Mothers Age Incidence (1 in ...)

35 400
36 290
37 225
38 180
39 140
40 109
41 85
42 70
43 50
44 40
45 32

Not sure about the fertility question but I know I've read somewhere it dips sharply after 35. Needless to say, I stopped reading and concentrated more on some early nights with DH!

Best of luck to your friend, motherinferior. Not sure these figures help at all really, but anyway there they are.

I know, EIGHT YEARS. The mind boggles, doesn't it. I reckon, myself, that fertility is quite specific to different women but as someone who got pregnant without even 'trying' at 37 and then again at 39, I'm one of MN's Do It Later crusaders!

I had dd at 41 and had no problem getting pregnant. If she's with the right man, then she should go for it (although after 8 years she's probably doing exactly that!).

Yes, it's not that, it's the research and the stats she feels she needs.

Hi , remind your friend that stats are at the end of the day just numbers and we are all different. DS was conceived at 37 and my tests said 1/750 chance of Down's. Far from what the numbers say for that age. Take each step at a time and in my opinion take all tests available.

Also buy her some energy drinks. Hats off to anyone who has a baby after 40. I feel half-dead and I'm only 34.

I know all the research agrees about the decline in fertility after 35, but I know an awful lot of women (including myself) who got pregnant very easily between the ages of 39 and 43. For a few of us it was a total shock as I guess we got a bit careless assuming that we just weren't particularly fertile any more. There is a theory that we have a "last chance" surge of fertility around this time, so hopefully this will hold true for your friend. I must say that I found the whole thing more tiring than when I had my first at 30, but part of that was due to the fact that I had two other children to look after as well. Good luck to her.

I am really not at all sure that 'facts' are what she needs. Apart from the Down Syndrome risk (which can be very accurately tested for) there really isn't a problem having babies later. Honestly. 'Other' chromosomal abnormalities are very, very rare whatever age you are and are usually entirely a fluke. Most can be tested fro via CVS. Any specific pregnancy risks connected with age are very varied and have really nothing to do with you as a person - ie there is an increased risk of diabetes, but that isn't really to do with age, but to do with the fact that we tend to be fatter as we age. If you are slimmish and fittish, your 'risk' is the same as any other slimmish and fittish woman.
As for fertility, the chance of getting pregnant doesn't 'plummet' after 35. In fact around 70% of 40 year old women are still fertile. It does plummet after that though and by 42, not that many of us (though some) are still fertile. But the only way to find out is to try! There is no other way. If you are fertile you will get pg, if not, you won't. Took me about ten minutes to get pregnant at 40 (nearly 41). We are all different.
Getting hung up on statistics is a bit silly tbh. Babies born to mothers over 40 are no less likely to be healthy, intelligent and loved. More so, if anything. But she can't afford to wait. If she and her dp want a baby, she should certainly NOT be using contraception and she should be necking the folic acid which may - just may help prevent Down Syndrome as well as cleft palate and spina bifida. (The DS thing is still theoretical atm btw)

Oh, and the age of your menopause is often inherited from your mother, and your fertility tends to decline very severely about ten years before your menopause sets in. But again, that is not set in stone.

Your miscarriage rate is up too, sadly, but you cannot ever predict whether it will happen to you. In my case, babies at 38 and 41, no problems conceiving and no miscarriages.

ooh, thanks. Will email her. xx

If your friend wants facts I would add the fact that having a baby at a later age and breastfeeding it actually lessens the likelihood of osteoporosis for the mother - just so she knows there are positive and beneficial things associated with late motherhood too(apart from having a child, obv)

Am sure you'll have heard of the article in the current BMJ re how women having children later are 'defying nature' - it's been galloping across the news this morning.

Haven't read it, but the article is here

There's an increased risk of all trisomies- so trisomy 21, 13 and 18. Other trisomies aren't viable. All would be picked up by a karyotpe (but not if you just had a specific test for Down's). You do have to wait a few weeks for a karyotype result though.

Actually this discussion about older mothers is really getting my goat (just listening to Woman's Hour). They're talking about it like it's ONLY up to women and is happening because women are more picky and / or career orientated these days - but it isn't a decision which happens in a vacuum. I'm not quite 'unnatural' yet, but I will be by the time we have (hopefully) our next one: even if I had wanted children ten years ago, I certainly didn't know any men of that inclination. What is one supposed to do? Steal the swimmers??

Hmmmm us naughty girls interfering with nature, leaving it too late,having careers....
Obstretricians NEVER interfere with nature do they? In fact when do they ever talk about the positives of nature when it comes to women, pregnancy and birth?
Shifting the goal posts to suit or what?!

I so agree, RedZuleika. It took me a long time to persuade DH that we should try for a baby - hence I was 33 when DS1 was conceived. Conceived DS2 two years later at 35 and DS3 at the age of 38.

And guess which child of mine has special needs? Yes, you got it, it's DS1 - the one who was conceived within the "optimum window" of 20 - 35 .

I spoke to my obstetrician about this when I had DD (was 37 for Ds and 39 for DD). She is private and I suspect that a large number of her patients are on the older side. She thought I was ok up to about 43 - said she would be relatively unconcerned about any pregnancy at that age. She said she would be more concerned between 43 and 45. Thereafter she said she would go as far as not recommending it. This of course, was for me with my history (about 8 months of clean living to conceive DS, 1 bottle of red wine to conceive DD). I had a CVS with DD and knowing that I was ok re testing she said that I should work on the basis that it would be a good idea if I had one if I got pregnant again. She certainly did not fall off her chair at the thought of anyone having a baby at those ages, but I think the big difference is that she knew that I could conceive and carry a baby to term.

I think your friend should go for it - I have a friend in a very similar position. Would definitely recommend she had a chat with an obstetrician if she is serious about it as she does not have a huge amount of time to play with.

I think if you spent too long pondering the risks and otherwise of older parenthood you'd never do it. All I could say to your friend (as someone who had kids at 37 and 41) is, if she wants to do it, go for it. Statistically she'll have less chance of conceiving than a 21 year olds so she may as well get cracking now. Having said that, I managed to conceive DS2 without even trying. In fact I'm still not sure it wasn't an immaculate conception now!