In today’s world, many people wait until after they’re 35 years old to begin their families. This may be due to not finding the right person or not being in the financial or career position to have a family until then. As every woman approaching 30 has been told, it can be harder to have a child as you get older, but the good news is around 1 in 5 pregnant Australians (20%) are between 35 and 39 years of age.

This guide to conception over the age of 35 will discuss how age affects fertility, how you can improve your chances of becoming pregnant and what to expect when pregnant over the age of 35. Having a healthy pregnancy over 35 is possible, and I’m here to support you! 

To understand how age affects fertility, starting with how eggs are developed is important. As women, we are born with all the eggs we will ever have, and by the time we reach puberty, there are approximately 400,000 to 500,000 follicles remaining. During a normal menstrual cycle, follicles (which contain a developing egg) are selected and develop to maturity. When a follicle has matured and grown to the right size, the follicle will rupture and releases the egg, which is now ready to be fertilised or become a period. The rest of the follicles that haven’t matured will undergo follicular atresia – a degenerative process that occurs regardless of whether you are pregnant, have a normal menstrual cycle, use hormonal contraception, or undergo fertility treatment. Smoking appears to accelerate atresia and is associated with earlier menopause.

Once we are over the age of 35, ovarian reserve (the number of healthy, immature eggs in the ovaries) decreases, reducing the monthly likelihood of conception and increasing the risk of miscarriage. This has a more serious impact on fertility when we’re over 45.

For women, egg quality also reduces as we get older. As we are genetically constructed to pass on the best information to the next generation, fertility is optimal for women at 18–35 years. The follicles that remain as we age are more likely to have abnormal chromosomes. And as we get older, we are more likely to have developed health conditions that can affect fertility, including uterine fibroids and endometriosis.

And as we get older, so do our partners! And while male fertility is different to female fertility in that men continue to produce sperm, their fertility is affected in other ways. As men age, sperm morphology and motility tend to decline, and there is a slightly increased risk of genetic defects in their sperm. 

Although we can’t reverse all the effects of aging (yet!), there are some things we can control. Fertility generally reflects an individual’s health and well-being, so being in the best place possible, physically and mentally, is important. Preconception care can start anytime before conception; ideally, it’s at least three months for egg and sperm development and address any nutritional deficiencies and other factors for optimal fertility.

Being in a healthy weight range improves fertility outcomes for both males and females. Women who are overweight have a higher incidence of menstrual dysfunction and anovulation (having a cycle without ovulation), which reduces the likelihood of conception. These women also experience an increased risk of subfertility and infertility and an increased rate of pregnancy complications and miscarriage. Overweight men are 11% more likely to produce low numbers of sperm and 39% more likely to produce no sperm at all. These risks increase to 42% more likely to have a low sperm count and 81% more likely to produce no sperm in obese men. Weight loss to achieve a healthy weight benefits conception outcomes for both males and females.

Other healthy lifestyle changes like quitting smoking and recreational drug use and reducing alcohol consumption will also improve your chances of conception.  Cigarette smoking lowers semen volumes, sperm counts, and the percentage of motile sperm in men. For women, smoking cigarettes can increase the time to conception, accelerate follicular depletion, which can lead to earlier menopause and increase the risk of miscarriage in early pregnancy. Alcohol consumption has been found to alter ovulation and menstrual cycle regularity and decrease sperm and semen quality. Consequently, quitting smoking and reducing alcohol intake positively impacts your fertility.

Endocrine-disrupting chemicals (or endocrine disruptors) are a diverse group of chemicals that have recently become a topic of interest because of their potentially harmful effect on human health, including fertility. This group of chemicals includes: 

• Pesticides
• Glyphosate
• BPA from plastic, and
• DEHP (used in medical devices, cleaning and building materials, personal care products, cosmetics, pharmaceuticals, food processing and toys)

Exposure to endocrine disruptors reduces both female and male fertility. They can decrease sperm motility, sperm count, and DNA integrity and increase the time to conception and the risk of miscarriage. Therefore, exposure to specific endocrine disruptors such as pesticides, BPA, and phthalates should be minimised in couples trying to conceive, given the evidence for negative effects on fertility and overall health.

Preconception care can start as soon as you consider trying for a baby! You don’t have to wait to book an appointment. 

If you’re a female, over 35 years, and have been trying to get pregnant for over six months, it might be time for some investigations. However, if you have endometriosis or another condition that affects your fertility, you can visit your doctor and request investigations sooner.

The good news is so many treatment options are available to improve your conception outcomes. Nutritional support is a great place to start optimising your reproductive health for conception. We want to prioritise antioxidants, omega-3 fatty acids, zinc, and vitamin D for optimal conception. 

Many fertility tests are available to determine if there are other factors impacting your chances of conceiving. This includes:

• General health assessments
• Prepregnancy assessments 
• Ultrasound to assess the pelvic anatomy of the uterus, including uterine lining and ovaries
• Male and female hormone profiles
• Thyroid function test
• Genitourinary infection screening
• Laparoscopy, hysteroscopy and salpingostomy

You may not need all of these tests and depending on the results, your treatment plan will be personalised to improve your chances of conception.  Depending on the results of your investigations, you may consider:

• Fertility medications such as Clomid and Follicle Stimulating Hormone
• Assisted reproduction therapy (ART) such as intra-uterine insemination (IUI) or in-vitro fertilisation (IVF)

If you’re going down the path of fertility medication or ART, nutrition support can support these treatments and improve your chances of conception.

Pregnancy over the age of 35 can look a little different to pregnancy at a younger age. Unfortunately, there is an increased risk of high blood pressure, pre-eclampsia, gestational diabetes, miscarriage and needing a caesarean section. Therefore you may require additional monitoring during your pregnancy. However, many of these risks are manageable with appropriate nutrition.

There are a few ways you can manage these increased risks in pregnancy, including seeking nutritional support early on to ensure you reduce your risk factors, particularly for complications like pre-eclampsia and gestational diabetes. Building an antenatal team around you that you trust is also important, as you’ll be spending a lot of time with them. Consider the model of care that you want for your pregnancy and delivery and how they can support you in this. 

And most importantly, enjoy your pregnancy! It can be hard to relax after wanting this baby for so long, but managing your stress and anxiety will make your pregnancy more enjoyable. Having a baby over 35 can have many wonderful outcomes – including a healthy mother and baby. I’m here to support you.

Looking to improve your chances of conception? Book a consultation with Court!

If you’re interested in taking any supplements, please discuss this with your practitioner to ensure you’re taking the correct dose and form for you. This article is not intended to be medical advice and is purely for education purposes.