Risk of miscarriage: how long should you be concerned?
At what point does the risk of miscarriage become low? Week-by-week figures, the effect of age, what does and does not increase the risk.
Read the articlePregnancy after 40: the figures, without sensationalism or false hope
A third of first-time mothers in France are now women over 35. After the age of 40, the subject is still treated either with alarmism or with examples of celebrities that don’t tell the whole story.
Two truths coexist. The first: fertility declines sharply after the age of 40, and much more rapidly than one might imagine. The second: the majority of pregnancies after the age of 40 proceed normally, with appropriate medical care. The challenge lies in achieving pregnancy, rather than carrying it to term.
The chances of conceiving
Naturally, the probability per cycle falls from around 20–25 per cent at the age of 30 to 5 per cent at 40 and 1–2 per cent at 43. After a year of trying, around 40 to 50 per cent of women aged 40 conceive, compared with 85 per cent at the age of 30.
With IVF using her own eggs, the live birth rate per transfer is around 6–9 per cent between the ages of 41 and 42, and falls below 5 per cent thereafter. How to interpret these figures is explained elsewhere. The reason is simple and well-known: the proportion of eggs carrying a chromosomal abnormality exceeds 70 per cent at the age of 42 and 85 per cent at the age of 44.
With egg donation, everything changes: around 50 per cent of transfers result in pregnancy, regardless of the recipient’s age, as it is the donor’s age that determines the quality of the eggs. This is the only factor that really makes a difference.
The first piece of advice, and it’s in chronological order
After the age of 40, do not wait a year before seeking advice: consult a specialist after three to six months, and have a full assessment carried out straight away. Every six months counts for more than the previous year, and the most costly mistake I see is waiting simply out of principle.
Obstetric risks, in figures
They are real, increased, and manageable:
- Miscarriage: around 40 per cent at age 42, over 50 per cent after age 44. The breakdown by week is here.
- Chromosomal abnormalities: the risk of Down’s syndrome rises from around 1 in 900 at age 30 to 1 in 100 at age 40 and 1 in 30 at age 45. Non-invasive prenatal testing is normally carried out.
- Gestational diabetes: two to three times more common.
- Pre-eclampsia and high blood pressure: the risk is approximately doubled.
- Placenta praevia, caesarean section, preterm birth: all show a moderate increase.
These figures justify closer monitoring, not giving up. Low-dose aspirin is often prescribed from the first trimester to reduce the risk of pre-eclampsia.
What an egg donation changes
It reduces the risk of miscarriage and chromosomal abnormalities to the level associated with the donor’s age – which is low. However, it does not eliminate the risks associated with your own body: high blood pressure, gestational diabetes and pre-eclampsia remain linked to your age, and are even slightly more common in pregnancies following egg donation, regardless of age. This is information that clinics provide far too rarely, and it must be taken into account when making a decision.
After the age of 45
With your own eggs, the chances are very low, and a reputable clinic will tell you this before charging for a cycle. With donor eggs, pregnancy remains possible: Greek law permits treatment up to the age of 54, with special authorisation required between the ages of 50 and 54. The article on IVF after the age of 43 sets out these guidelines in detail. At these ages, a thorough cardiovascular, blood sugar and uterine assessment must be carried out before any decision is made, and an early obstetric consultation is advisable — because the issue is no longer simply about becoming pregnant, but about carrying the pregnancy to term under the right conditions.
What I tell 41-year-old patients
Get your assessment done now. If your ovarian reserve is adequate, one or two attempts using your own eggs are a viable option, with a timeframe set in advance. If it is low, it’s worth having a conversation about egg donation early on, even if you’re not ready to make a decision. It is not the decision itself that closes the door: it is the time spent putting it off.
Frequently asked questions
What are the chances of getting pregnant at 40?
Around 5 per cent per cycle naturally, and 40 to 50 per cent after a year of trying. With IVF using your own eggs, the live birth rate is 6 to 9 per cent per transfer between the ages of 41 and 42.
When should you seek advice after the age of 40?
After three to six months of trying, not a year. A full assessment should be carried out immediately, as every six months counts for more than the last.
Does egg donation eliminate the risks?
No. It reduces the risk of miscarriage and chromosomal abnormalities to the level associated with the donor’s age, but high blood pressure, gestational diabetes and pre-eclampsia remain linked to your age and are even slightly more common in pregnancies achieved through egg donation.
Up to what age is pregnancy possible with egg donation?
Greek law permits treatment up to the age of 54, subject to special authorisation between the ages of 50 and 54 and a more thorough medical assessment.
Sources
This article provides general practical and administrative information. It does not constitute medical or legal advice. Rules and costs are subject to change: always check for the latest information with your health insurance provider, the clinic treating you and your doctor.
Source: https://fertilitegrece.com/en/blog/pregnancy-after-40/ — Triada Baloukoudis, IVF patient coordination in Greece. General information, not medical or legal advice. Printed on
Triada Baloukoudis
Independent IVF patient coordinator in Thessaloniki, with 24 years of experience supporting patients travelling from abroad. More · Contact · Facebook
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