Couples struggling to conceive usually have one burning question in mind: How likely is it that I will get pregnant? The truth is the answer to this question is complex. Several factors influence a person’s chances of getting pregnant, including age, fertility history, and overall health.
According to the American College of Obstetricians and Gynecologists (ACOG), a woman’s peak reproductive years are between her late teens and 20s. By the time she reaches her early 30s, the chances of getting pregnant begin to decline. From 35 onwards, this decline becomes steeper, and the odds of getting pregnant naturally drop significantly.
This article breaks down the chances of getting pregnant by age and provides some insight into how to improve those odds.
Odds of Getting Pregnant by Age Chart
The following data from the American Society of Reproductive Medicine (ASRM) demonstrates the odds of natural pregnancy by age per month.
| Age (years) | Odds of a Natural Pregnancy by Age Each Month |
|---|---|
| 25 | 25% |
| 30 | 20% |
| 35 | <15% |
| 40 | <5% |
The table below shows the likelihood of a natural pregnancy within one year of trying.
| Women’s Age | Chance of Getting Pregnant by Age Within 1 Year |
|---|---|
| 20-24 | 86% |
| 25-29 | 78% |
| 30-34 | 63% |
| 35-39 | 52% |
Common Factors Affecting Your Chances of Fertility and Pregnancy
Getting pregnant can be a complex process that involves several steps, and many factors can impact a couple’s chances of success.
Steps of Pregnancy
Before we go any further, let’s review what it takes to get pregnant.
Pregnancy involves the following steps:
Ovulation
Ovulation occurs when an ovary releases an egg. The egg travels down the fallopian tube, where it may (or may not) encounter a sperm. Ovulation occurs approximately 14 days before the onset of menses, so in women with a 28-day cycle, ovulation occurs around cycle day 14. For women with a 30-day menstrual cycle, ovulation occurs around cycle day 16.
Fertilization
Fertilization occurs when sperm penetrates the egg. This happens in the fallopian tube. The fertilized egg becomes an embryo. As it travels down the fallopian tube, the embryo divides and grows so that by the time it reaches the uterus, it is a blastocyst (an approximately 300-cell embryo).
Implantation
Once the embryo emerges from the fallopian tube, it bonds with the uterus wall. This process is called implantation, and it marks the beginning of pregnancy. It takes 6-10 days after ovulation for the zygote to reach the uterus and implant in the uterine lining.
Reasons for Not Getting Pregnant
Infertility isn’t a one-size-fits-all issue; many potential factors can impact a person’s chances of getting pregnant. Here are a few factors that can affect fertility and pregnancy:
- A history of pelvic inflammatory disease (PID)
- Irregular menstrual periods or no period at all
- Endometriosis
- Polycystic ovary syndrome (PCOS)
- Advanced maternal age
- Diminished ovarian reserve or poor egg quality
- Low sperm count or poor sperm quality in the male partner
- History of miscarriage or ectopic pregnancy
- Prior use of chemotherapy or radiation therapy
- Issues with the uterus or fallopian tubes, such as fibroids or blockages.
- A history of testicular trauma or injury in the male partner
- Unexplained Infertility
- Stress
How Aging Affects Fertility and Pregnancy
Aging is a natural process that impacts many areas of our lives, including fertility and pregnancy.
While getting pregnant at almost any age is possible, the chances decrease as people age. Here’s why: Individuals are born with a finite number of eggs (around two million), and as they age, the quantity and quality of those eggs decrease.
From those two million eggs, about 500 eggs will be ovulated over a lifetime; the rest will undergo follicular atresia and disappear. And, just as an individual’s egg supply decreases with age, so does the quality of those eggs, which can result in abnormal eggs that may not fertilize or implant properly.
This decline leads to the inevitable phase of life known as menopause. During this time, an individual’s ovarian reserve is in the hundreds, and eggs are no longer released regularly.
Age and Fertility: Getting Pregnant at an Older Age
Fertility declines with age, but many individuals can conceive and carry a healthy pregnancy into their 30s and 40s. The following sections cover everything you need to know about the likelihood of getting pregnant at an older age.
Getting Pregnant at 30, 35, 40, 45
Research shows that most women reach their peak fertility in their mid-to-late 20s when they have more normal eggs in their ovaries than abnormal ones. As women age, the quantity and quality of eggs decrease, leading to age-related infertility, miscarriage, and aneuploidy, making it harder to conceive naturally or through IVF.
By the time a woman reaches 35 years old, her aneuploidy rates increase significantly, and at 40, most of her eggs are aneuploid (abnormal), decreasing her chances of pregnancy and successful birth. Even with IVF, the chances of success are quite low in women in their early 40s.
RMA’s Dr. Jason Franasiak completed a study in 2013 that analyzed the rate of genetic abnormalities in women’s eggs by age. Dr. Franasiak looked at embryo biopsy data from IVF patients and saw how the aneuploidy rate climbed with age.
While most of the data in Dr. Franasiak’s study accurately reflect the risk of aneuploid in embryos by patients’ age, it is important to review the data in the youngest age groups with a grain of salt. While the study showed aneuploidy rates over 40% for 22 and 23-year-old women, the youngest women in this analysis likely had a higher rate of intrinsic genetic issues, thereby skewing the aneuploidy data in the youngest age groups.
Your Chances of Getting Pregnant at Every Age
This section explores common questions about age and fertility, including the latest research on age and fertility and what happens when a healthy or abnormal egg ovulates. We also cover the aneuploidy rate by age and discuss ways to increase your chances of getting pregnant.
Does your chance of getting pregnant decrease with age?
Yes, fertility decreases with age, but getting pregnant at an older age is still possible.
Dr. Franasiak’s study shows that fertility is influenced by age. After age 37, a woman’s chances of ovulating a normal egg decrease to less than 60% each month.
While a woman may still consider a 60% chance of ovulating a normal egg each month good, it’s important to remember that not all normal eggs lead to a successful pregnancy. There are multiple other factors beyond genetics, including uterine receptivity and timing of embryo growth, that influence the ability of a fertilized egg to implant.
On top of that, aneuploidy rate increases faster after 37 and very rapidly after 40. Because aneuploidy usually means no pregnancy or a miscarriage, a high aneuploidy rate indicates a low sustained pregnancy rate.
Dr. Franasiak’s data also helps us understand the prevalence of miscarriages among different age groups. Since we know that aneuploidy is the leading cause of miscarriage, we can assume that women in age groups with high aneuploidy rates are also more likely to have high miscarriage rates.
In other words, as women age, their chances of conceiving decrease; if they become pregnant, their chances of experiencing a miscarriage increase.
Euploid Embryo vs. Aneuploid Embryo
When an embryo develops, it can become abnormal if the egg or the sperm has a genetic abnormality. Typically, genetically healthy people have 46 chromosomes, which consist of 22 numbered pairs and one pair of sex chromosomes that determine a person’s sex.
An embryo with 46 chromosomes is considered euploid or chromosomally normal, while an embryo with 45 or 47 chromosomes is considered aneuploid or chromosomally abnormal.
Unlike men’s sperm, which largely remain genetically healthy into late adulthood, women’s eggs can have abnormalities at any point in their reproductive lifespan. The likelihood of such abnormalities increases with age. As women age, their eggs undergo age-related changes, leading to a higher chance of abnormal eggs in their egg reserve. If an abnormal egg ovulates, it can result in an abnormal embryo.
It’s important to note that while aneuploidy can result from abnormal sperm, it’s more common for it to occur from an abnormal egg, particularly in couples where the woman is over 37 years old.
What happens when a healthy, normal egg ovulates?
When a normal egg meets a normal sperm, it results in a euploid embryo. The chances of conception and live birth are high with a euploid embryo. This is why genetic testing of the embryo is now a routine procedure at fertility clinics, as it plays a crucial role in achieving success.
However, despite genetic testing and other advanced technologies, pregnancy is still a complex process, and even with a euploid embryo, there’s no guarantee of successful implantation or pregnancy. Even for a fertile young couple, the chances of getting pregnant in any given month are approximately 20%.
You can view RMA’s IVF success rates here.
What happens when an abnormal egg ovulates?
When an abnormal egg is fertilized by sperm, it creates an aneuploid embryo.
If that abnormal aneuploid embryo successfully implants in a woman’s uterus, it can lead to pregnancy. Aneuploid pregnancies typically end in miscarriage. However, they may result in ongoing, genetically abnormal pregnancies.
Miscarriage is common. The risk of miscarriage increases as a woman gets older.
In rare cases where an aneuploid embryo holds on, and the pregnancy is carried to term, it may result in the delivery of a child with a genetic abnormality. Down syndrome is the most common of these conditions, occurring when a baby has three copies of chromosome 21.
Rate of Aneuploidy by Age
The rate of aneuploidy, or the proportion of abnormal eggs, increases as women age.
Here are the estimated percentages of aneuploidy at different ages:
- At age 29: about 20% of eggs are aneuploid
- At age 31: about 30% of eggs are aneuploid
- At age 35: about 35% of eggs are aneuploid
- At age 37: about 42% of eggs are aneuploid
- At age 40: nearly 60% of eggs are aneuploid
- At age 44: nearly 90% of eggs are aneuploid
The chances of aneuploidy can vary among individuals and may be affected by lifestyle, genetics, and environmental exposures.
How to Increase Your Chances of Getting Pregnant
While getting pregnant can be challenging for some couples, you can do a few things to increase your chances of conception and successful pregnancy.
Here’s a quick rundown of some tips:
- Understand your menstrual cycle and ovulation window: Knowing when you’re ovulating and having regular sex during your fertile window can improve your pregnancy odds. Ovulation typically occurs around day 14 of a woman’s cycle, but this can vary from person to person, so tracking your cycle with tools like ovulation predictor kits or fertility apps may be helpful. You can also monitor your basal body temperature or check for changes in your cervical mucus.
- Have sex frequently: Having sex regularly during your fertile window can increase your chances of conception. Sperm can live inside the female reproductive tract for three days, so you’re more likely to get pregnant when live sperm are present during ovulation.
- Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and avoiding smoking and excessive alcohol consumption can all help improve your overall health and increase your chances of getting pregnant.
- Take prenatal vitamins: Prenatal vitamins containing folic acid, iron, and other essential nutrients can help prepare your body for pregnancy and reduce the risk of birth defects.
- Manage stress: High-stress levels can negatively impact fertility, so finding ways to manage stress and relax can be beneficial.
- Consider fertility treatments: If you’ve been trying to conceive without success for a while, fertility treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF) may be an option. These treatments can help overcome fertility challenges and increase your chances of pregnancy.
It’s important to seek medical advice and discuss family planning with your doctor or OB-GYN, especially if you’re having difficulty getting pregnant or have a history of fertility issues. They’ll be able to identify any underlying medical conditions contributing to infertility and recommend appropriate treatments or refer you to a specialist if needed.
Additionally, discussing family planning with a healthcare professional can help you make informed decisions about your reproductive health and future. They can provide birth control or other contraceptive options and help you plan for a healthy pregnancy when the time is right.
Regular check-ups and open communication can help you take the necessary steps to optimize your reproductive health and achieve your family planning goals.
What if I can’t get pregnant naturally? Will IVF help?
If you’re struggling with infertility due to age or other factors like PCOS or endometriosis, seeking help from a fertility doctor is important.
Mild infertility can often be treated with Intrauterine Insemination (IUI), a procedure in which a doctor places sperm directly into a woman’s uterus during ovulation. Medications may also be used to increase the number of eggs released.
However, IVF is often the recommended treatment option for more advanced cases. IVF has the highest success rates and can dramatically improve live birth rates for infertile couples, allowing them to build a family.
It’s important to note that even women who conceive quickly with their first child may struggle with infertility later. It’s also shocking when that same woman, several more years later, conceives naturally and gives birth to a healthy baby.
While these surprise success stories are less common than one would like, they certainly happen.
A Word from Reproductive Medicine Associates (RMA)
At Reproductive Medicine Associates (RMA), we understand that fertility can be a complex and emotional experience, and we’re here to support you every step of the way. Our team of experts is dedicated to providing compassionate care and personalized treatment options to help guide your fertility journey and achieve your dream of having a child.
Don’t hesitate to contact us for more information or to schedule a consultation.
