Fertility in your forties – everything you need to know

Tick tock goes the clock… Lianne Kolirin looks into the reality of having children later in life. Age may just be a number but when it comes to fertility you can’t ignore the pace of time. 

Fertility declines with age. It’s an indisputable fact that is frequently reinforced by medical professionals and the media.

Yet, if you cast an eye towards Hollywood, you could be mistaken for thinking otherwise. The film industry is teeming with strong female role models who have chosen to delay motherhood for the sake of their careers. But have they sacrificed the chance of a family for their moment in the spotlight?

Far from it.

Nicole Kidman, who shares two adopted children with ex-husband Tom Cruise, first gave birth aged 40 and again two years later. Singer Celine Dion had twins at 42. Halle Berry was 47 when she had a child with husband Olivier Martinez, while John Travolta’s wife Kelly Preston was 48 when she had third child Benjamin.

Jade Jagger is due to give birth in May – at the same time as becoming a grandmother for the first time. The list of fabulous forty-something mothers, including the likes of Salma Hayek, Amanda Holden, Uma Thurman and Mariah Carey, goes on and on.

So if they’re all at it, what’s the true picture for the rest of us?

According to the Office of National Statistics (ONS), the number of women having babies over the age of 40 has risen fourfold over the last three decades. In 1982 there were 6,500 births to women in that age group in England and Wales, which amounted to one per cent of all births. By 2012, there were 30,000 equivalent births, representing four per cent of all births. But what has changed? The movement for equal rights may have revolutionised opportunities in the workplace, but science has made little impact on the pace at which our biological clocks tick away.

Earlier this year Professor Dame Sally Davies, Chief Medical Officer for England, expressed concern at the “steady shift” of women postponing motherhood until their late 30s and early 40s, thereby reducing the chance of conception and increasing the risk of medical complication.

She said, “The steady shift to have children later, there are issues with that. We all assume we can have children later but actually we may not be able to.”

Despite having herself had two children in her forties, Prof Dame Sally said there is no denying that fertility declines as women get older.

“As couples we have to face that,” she said.

There are many reasons women delay having children. Perhaps they have chosen to focus on their careers or fulfil educational or travel dreams. It may be a simple case of not having met Mr Right. While some women breezily defer their decision to some undetermined point in the future, others are all too aware of the quickening pace of time.

With age, your chances of falling pregnant decrease as the quantity and quality of your eggs deteriorate. Women over 35 may find it more difficult to fall pregnant and it may take longer to do so. While there are many who fall pregnant naturally and go on to have healthy babies, a considerable proportion of older women will require some form of fertility treatment.

“We know from the data that the trend is growing,” says consultant obstetrician Daghni Rajasingam, a spokeswoman for the Royal College of Obstetricians and Gynaecologists (RCOG).

“The risk of all common pregnancy complications increases as you get older.” According to Dr Rajasingam, that involves everything from conception and pregnancy to childbirth and the health of mother and baby post-partum.

“Miscarriage is more common, as is bleeding in pregnancy and pre-eclampsia. Then you are also more likely to need a caesarean or the assistance of certain instruments during delivery.”

Unfortunately the potential difficulties do not end there, as older women are more likely to suffer from clots, infections and recurrent blood pressure issues following the birth. A baby born to a woman in her forties is also more likely to suffer from foetal abnormalities, such as structural or chromosomal conditions.

It is harder to fall pregnant naturally at an advanced age and so many women turn to IVF. But according to Dr Rajasingam, it is important to manage expectations. Any woman who is hoping to fall pregnant is advised to be in good health, but this is all the more important if you are older.

She says, “Make sure you are physically fit and of a healthy weight. Be aware of the risks and talk to a healthcare professional to get some advice. Part of the problem is that women are not aware of the issues involved.”

That said, women over forty who are hoping to fall pregnant should not panic, according to a spokesman for the Family Planning Association.

He says, “Fertility is not something that disappears overnight. You don’t get to 34 years and 364 days able to have children, and wake up the next morning infertile.”

“If you are planning children then it is important to be mindful of your own fertility, as it does of course decline with age, and it does not happen to all women at the same time. It’s also important to remember that there are many reasons why a woman might not be able to conceive – and it’s not always linked to age.”

So, by the same token, women who do not want to get pregnant should still take precautions. He says, “When we see stories in the media about women struggling to conceive as they get older, it is easy to assume that as you get into your 40s you might not need to use contraception anymore.”

✽ Your chances of becoming pregnant decrease as you get older as the quantity and quality of eggs deteriorate with age. It can take longer and be more difficult to get pregnant if you are over 35. However, many women over 35 have healthy pregnancies and babies.

Natalie and Danny Somekh were perfectly content with their family of four and planned to stop there.
But things changed when Natalie hit her late thirties and all around her were going for number three.
“It was as if something reminded me that soon I would be 40 and it was the last chance of having another one,” she says.
The couple deliberated about the cost and logistics before deciding to go for it. Natalie fell pregnant at 38, but tragedy struck seven months later when the baby was found to have no heartbeat.
“It was devastating,” says Natalie. “The grief, having to be strong for the children, plus Danny was made redundant two weeks earlier.”
The despair deepened as Natalie then suffered another miscarriage, though within a year she fell pregnant with Jonah, now three.
The pregnancy was “full of anxiety”, according to Natalie, 44.
“I had to have more regular tests. Because of my age and blood test results, I also had to have the placenta test which detects Down’s syndrome.”
Being an older mother is more tiring and Natalie admits to losing her patience quicker, but there are positives too.
“The pressures of having three is there at any age,” she says.
“Yet knowing how the time goes by, I also appreciate everything about having a child and cherish those special moments.”

Claudine Gilbery-Phillips always knew she wanted children, but finding Mr Right was less straight forward.
As her milestone fortieth birthday approached, Claudine made a life-changing decision and decided to go it alone. But when her doctor sent her for tests, she was found to have an alarmingly low level of fertility hormone AMH.
With almost no chance of conceiving naturally, Claudine opted to use a donated egg and sperm and luckily fell pregnant immediately – with identical twin boys.
Then, at four months, she had a chance encounter on a friend’s Facebook page with a man called Mark. They met soon afterwards and within a fortnight Mark proposed.
Mark was present at the birth in November 2011 and later went on to adopt Samuel and Oliver.
“It’s a bit of a fairy story,” says Claudine.
“I never thought I was going to meet anyone and that’s why I got pregnant on my own.”
Aged 54 and with two older children from a previous relationship, Mark now spends three days a week looking after the children while Claudine works in the City.
“Mark is on their birth certificates and they have his name. He is the most incredible dad and husband.”
Yet the chances of a sibling for the twins is highly unlikely, according to Claudine.
“I hated being pregnant and I found the first six months very hard,” she says.
“Of course I wished I could have had them earlier because of my energy levels, but if I’d done it any earlier I wouldn’t have met Mark – or had Samuel and Oliver.”