18 Jan Conceiving After 40
There is an increasing number of women who are trying to conceive over the age of 40. There are a variety of unique challenges with trying to conceive and with the conception itself. It asks for an adequate preparation before one embarks on this journey. There are several important areas to focus on in order to ensure a successful conception and having a healthy baby.
Why is the age of 40 significant? It is because climacteric statistically begins at 40. It is a natural process where the menstrual cycles begin to shorten. This is because the ovaries start to produce fewer mature follicles, and therefore lesser estrogen and progesterone. Climacteric leads to menopause, which is confirmed once a woman has not had her menstrual cycle for at least one full year. The range of menopause is said to be 40-55, and in fact, may take 1-7 years to complete.
There are 3 distinct phases of climacteric:
- Phase 1 Perimenopause: 2 to 8 years leading up to the cessation of menstruation, during which menstrual cycles become irregular and hormone levels change. It is still possible to conceive naturally in this phase.
- Phase 2 Menopause: Defined by the absence of menstruation for one year. Elevated FSH and LH levels confirm it.
- Phase 3 Post-menopause: This last stage usually ends by age 58-60.
During climacteric, fertility diminishes as muscles of the vagina, cervix, uterus and ovaries atrophy, muscles in the pelvic floor and surrounding supportive tissues lose tone, cervical mucus decreases, bone mass declines, metabolic rate slows down. There are hot flashes, mood changes, depression, insomnia, and anxiety.
To ensure healthy fertility over 40 entails several important steps – eating well, exercising regularly, reducing poor lifestyle choices, and most importantly, seeing a fertility specialist. The latter is especially true if you have to try on your own with no success for the past 6 months. The typical workup will include a full hormone test panel and other tests may be necessary to ensure that there are no fertility issues that may be hindering conception and pregnancy.
It is important to focus on factors that improve ovulation, uterine lining, hormonal balance, pelvic floor muscles strength, cervical mucus production, etc. There is also a need to ensure that the stress levels are low and that the ovulation timings are meticulously noted and sexual intercourses coordinated accordingly.
In case where these steps alone don’t help and there is a major concern about falling ovarian reserve, assisted reproductive therapies may be considered. This can be as simple as taking Clomid to stimulate ovulation, to more involved procedures, such as intrauterine insemination (IUI), in vitro fertilization (IVF), etc. Even if one of these options are chosen, the aforementioned natural processes are very important to adhere to. If there is an underlying infertility issue, it must be diagnosed early and accurately and proper management must ensue in order to salvage any chance of conception that may still exist.