Child-Bearing Basics for Couples Over 40

Either by choice or due to unintended life circumstances, more and more couples are waiting until later in life to have a child. The reason a couple may be trying to conceive after they've both celebrated the big 4-0 doesn't really matter, because at that point, fertility will be an issue anyway. Whether you are in a couple or looking to become a single parent, if you're struggling with fertility, in vitro fertilization (IVF) and intrauterine insemination (IUI) are options, along with surrogacy and adoption.

How age affects fertility

Most people know that it's more difficult for women to conceive as they get older. The same can be true for men. Research shows that men older than 40 are 30 percent less likely to get a woman pregnant during one year of unprotected sex compared to men under 30 (adjusting for a female partner's age). An increase in erectile dysfunction and a decrease in sex frequency can also play a role in the dwindling fertility rates of aging men.

Miscarriage can be linked to age, too. The leading cause of miscarriage is an embryo carrying abnormal chromosomes. Since genetic mutations increase over time for both men and women, the rate of pregnancy loss does, as well. At age 30, it's estimated that 30 percent of a woman's eggs possess abnormal chromosomes. This increases to 60 percent at age 40 and about 90 percent by age 44. Due to this increase in abnormalities, it can be difficult for women over 40 to experience a viable pregnancy using their own eggs.

Treatment options

Multiple treatment options are typically available for any manner of fertility problems. Some couples start with IUI, which is a less-invasive procedure that is useful for men with a low sperm count or impaired sperm motility, because the sample can be specially prepared and concentrated to include a higher number of viable semen. Fertility is enhanced when viable sperm and an egg are brought closer together, which IUI accomplishes.

If IUI is unsuccessful, IVF is often the next step. During IVF, a doctor will control when a mother ovulates through the use of hormone treatments. Sperm samples are collected, purified and preserved. Once several eggs become available, they're carefully harvested and combined with sperm cells to produce embryos. After being tested for chromosomal abnormalities, an embryo is then selected for implantation in the hopes of creating a viable pregnancy.

Remember, too, that overall health factors play into fertility at any age. Exercising regularly, eating well, avoiding excess weight gain, minimizing stress and not smoking are all healthy choices that boost the chances of conception for both men and women.

Donors & surrogacy

If traditional IVF doesn't work, you may want to consider using donor eggs or sperm. Donor eggs can improve the chances of IVF success for women over 40 by up to 70 percent. A similar live birth rate is seen among women ages 30 to 47 when donor eggs are used and all other factors are the same. Similarly, sperm quality issues can be avoided with sperm donation.

When fertility issues stem from the woman's inability to carry a pregnancy to term, surrogacy can pave the way to a biological child. Your fertility clinic can provide the testing and referrals necessary to explore all methods of treating infertility based on your unique situation.

Alternatives to keep in mind

Even if you have trouble conceiving with IVF, always remember, you have options. The road to parenthood isn't the same for everyone. Fostering and adoption are wonderful ways to connect with a child in need. According to data from UNICEF, there are approximately 153 million orphans around the world. In the United States, more than 435,000 kids are in foster care and another 115,000 are waiting to be adopted. The hope for having a child doesn't have to end with IVF.