How does the mother’s advanced age influence pregnancy?

By (gynecologist), (gynecologist), (gynecologist), (embryologist) and (embryologist).
Last Update: 06/06/2023

Fertility preservation is a recommended alternative for women who wish to delay their desire for motherhood.

Regardless of the effects of age on female fertility, it is important to consider that advanced maternal age can increase pregnancy and childbirth complications.

For instance, a pregnancy at an advanced age carries a higher risk of preeclampsia. Similarly, the baby is also at a higher risk of chromosomal abnormalities and an increased probability of having Down syndrome, for example.

Advanced maternal age and fertility

Today, there is a tendency to delay childbearing due to socioeconomic issues. Among other reasons, the insertion of women into the labor market and the methods available to control childbearing have caused, in recent years, a significant increase in the number of pregnancies in women over 35 years of age.

Biologically there has not been this evolution and fertility is still limited by age. This means that, from a physiological point of view, maternal age is considered to be advanced from 35-40 years of age.

The years have an impact on the ovarian reserve, since both the quality and quantity of the eggs are progressively diminished with the passage of time.

One of the most frequent alterations in the eggs of older women is the increased incidence of aneuploidy. This means that your oocytes are more likely to not have the correct chromosomal load, which means that pregnancy is more difficult to achieve and the risk of miscarriage is higher.

What options does assisted reproduction offer?

In order to overcome these drawbacks, reproductive medicine offers two options:

  • Social fertility preservation: consists of freezing eggs when you are younger (20-30 years old) to be able to use them later, when you want to become a mother and it is no longer possible with the eggs available in the ovary at that time.
  • Egg or embryo donation: in cases where it is not possible to achieve gestation with one's own oocytes, donated oocytes or embryos can be used.

These alternatives are viable because the receptivity of the endometrium (i.e., the ability of an embryo to implant in it) is not as influenced by age. Nevertheless, as we will detail below, it must be taken into account that carrying a pregnancy to term at an advanced age entails more obstetric risks.

Delayed childbearing and pregnancy

Advanced maternal age is a risk factor, both during pregnancy and childbirth.

We must not forget that pregnancy is a special physiological state, with a strong hormonal variation and, therefore, it is not exempt from possible complications or risks.

With age, the body loses firmness, strength and capacity. This means that the body's responses to special situations, such as the changes of pregnancy, are not as adequate or bearable compared to the body's response at younger ages.

Possible risks of pregnancy

It has been observed that, in women over 35 years of age, pregnancy can lead to obstetric problems with greater probability. Some examples can be found in:

On the other hand, the rate of prematurity and delivery complications, such as cesarean sections or instrumental deliveries (using external elements to remove the baby), occur to a lesser extent in younger women. Approximately 10% of deliveries in elderly women are preterm.

In addition, babies are more likely to have low birth weights and perinatal (near birth) death rates are higher.

Although it may seem contradictory, multiple pregnancies are also more likely to occur at older ages. This is due to hormonal imbalances that cause more ovulations of more than one egg.

It has also been observed that both chromosomopathies (alteration in the number of chromosomes) and non-chromosomal malformations are more frequent in this type of women. This increases the likelihood of miscarriages.

For all these reasons, it is advisable that women who become pregnant after 35-40 years of age follow a more exhaustive gestational control, performing more prenatal tests than younger patients.

FAQs from users

From what age is it advisable to have a PGT?

By Elena Santiago Romero M.D. (gynecologist).

PGT is a technique that allows the study of the embryo's karyotype and is indicated for several reasons. One of them is the woman's age. From 38 years of age onwards, we will recommend it after IVF because we know that the rate of chromosomally altered embryos (aneuploid) increases exponentially with respect to younger women and, the older the woman is, the lower the probability of having healthy embryos.

This explains why the probability of pregnancy becomes less and less with the passage of time, just as the probability of miscarriage increases with age.

Why does the mother's age affect pregnancy?

By Héctor Iván Izquierdo Urdinola M.D. (gynecologist).

In the field of fertility, there are few factors as important in conceiving as a woman's age. There are several reasons that make age one of the biggest challenges in this process. Among them are oocyte and embryonic factors, endometrial factors, immune factors and general health status.
Read more

What is the ideal age to become a mother?

By Marta Barranquero Gómez B.Sc., M.Sc. (embryologist).

There is no such thing as an ideal age to become a mother. The important thing to keep in mind is that age is an essential factor for female fertility.

As a woman's age advances, her number of available eggs decreases until they are depleted. For this reason, it is often said that the best age to achieve pregnancy is between 18 and 35 years of age.

After the age of 35, many women find it difficult to conceive. In these cases, the solution would be to resort to assisted reproduction techniques.

Can freezing eggs cause them to have more chromosomal alterations?

By Carmen Ochoa Marieta M.D., Ph.D., M.Sc. (gynecologist).

The results obtained to date demonstrate that vitrification and devitrification of the oocytes preserves the initial quality of the oocyte in relation to the structure of its meiotic spindle and metaphase plate, as well as the potential necessary to support subsequent embryonic development.

At what age does a woman lose fertility?

By Rebeca Reus BSc, MSc (embryologist).

A woman's fertile period ends with the onset of menopause, approximately at the age of 50. However, there is no exact age at which fertility is lost, since each woman is different and ages at a different rate. However, it is true that after the age of 35 the chances of conceiving naturally decrease considerably, being more difficult to achieve in the years after 40.

Does a multiple pregnancy carry more risks?

By Rebeca Reus BSc, MSc (embryologist).

Yes, because more changes in the body are necessary to carry it out. Therefore, in advanced ages, it can also mean more problems, since it is a complicated situation.

Up to what age can I resort to ovodonation?

By Rebeca Reus BSc, MSc (embryologist).

Endometrial receptivity is not as affected by age as ovarian reserve. However, although there is no legal limit, for medical and ethical reasons, in Spain there is a consensus among clinics that limits the age to undergo assisted reproduction treatments to 50 years of age.

Suggested for you

As we have seen, preserving fertility is a key factor in being able to become a mother at an advanced age with your own eggs. We suggest you visit the following link if you want to know more about this process or if you are considering delaying your childbearing: What is fertility preservation?

This treatment is possible thanks to the fact that, in recent years, the technique of egg vitrification has been optimized. It consists of freezing the oocytes with little damage. Did you know that they are kept at -196ºC until they are used? You can find more information here: What is egg vitrification?

However, if you have not preserved your fertility in time, it is also possible to resort to egg donation to become a mother when your ovarian reserve is already limited. We invite you to visit the following link to learn how this process works: How are the ovodonation treatments?

Although these alternatives exist, it is important to remember that pregnancies at certain ages may carry more risks. You can read the following article if you want more information about the associated problems: Can I be a mom over 40?

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FAQs from users: 'From what age is it advisable to have a PGT?', 'Why does the mother's age affect pregnancy?', 'What is the ideal age to become a mother?', 'Can freezing eggs cause them to have more chromosomal alterations?', 'At what age does a woman lose fertility?', 'Does a multiple pregnancy carry more risks?' and 'Up to what age can I resort to ovodonation?'.

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Authors and contributors

 Carmen Ochoa Marieta
Carmen Ochoa Marieta
M.D., Ph.D., M.Sc.
Bachelor's Degree in Medicine from the Basque Country University. PhD in Medicine & Surgery from the University of Murcia. Currently, she is the director of the Assisted Reproduction Unit of Centro de Estudios para la Reproducción (CER SANTANDER) in Santander, Spain, as well as the director of the Diagnostic Unit of Human Assisted Reproduction in Bilbao. More information about Carmen Ochoa Marieta
License: 484805626
 Elena Santiago Romero
Elena Santiago Romero
Bachelor's Degree in Medicine and Surgery from the Autonomous University of Madrid. Master's Degree in Human Reproduction from the King Juan Carlos University and the Valencian Infertility Institute (IVI). Several years of experience as a gynecologist specializing in Reproductive Medicine. More information about Elena Santiago Romero
License: 282864218
 Héctor Iván Izquierdo Urdinola
Héctor Iván Izquierdo Urdinola
Dr. Izquierdo has a degree in Medicine and Surgery from the Universidad del Valle. In addition, he has a course in basic psychosomatic care by the Institute of Psychotherapy and Psychoanalysis of the University of Würzburg, a Master in Assisted Human Reproduction by the University of Salamanca and the title of Gynecologist and Obstetrician by the Government of Upper Bavaria, Germany. More information about Héctor Iván Izquierdo Urdinola
Member number: 03-0312760
 Marta Barranquero Gómez
Marta Barranquero Gómez
B.Sc., M.Sc.
Graduated in Biochemistry and Biomedical Sciences by the University of Valencia (UV) and specialized in Assisted Reproduction by the University of Alcalá de Henares (UAH) in collaboration with Ginefiv and in Clinical Genetics by the University of Alcalá de Henares (UAH). More information about Marta Barranquero Gómez
License: 3316-CV
 Rebeca Reus
Rebeca Reus
BSc, MSc
Degree in Human Biology (Biochemistry) from the Pompeu Fabra University (UPF). Official Master's Degree in Clinical Analysis Laboratory from the UPF and Master’s Degree about the Theoretical Basis and Laboratory Procedures in Assisted Reproduction from the University of Valencia (UV). More information about Rebeca Reus

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