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Pregnancy After 40: What to Consider and How to Approach It

Home > Blog > Fertility

By Dr. Elisa Pérez (Gynaecologist – Reg. No. 203311163).

Key points, care and essential recommendations

In recent decades, the number of pregnancies among women over the age of 40 has increased significantly. In Spain, 10.4% of births recorded in 2024 corresponded to women aged 40 or older, compared to just 7.2% ten years ago.

This change is not accidental or driven by trends, but by a broader transformation in society. Many women choose to postpone motherhood for valid reasons such as pursuing higher education, advancing their careers, achieving job and financial stability, or taking on positions of greater responsibility. Delaying motherhood does not mean giving it up. It simply means choosing the right moment based on personal circumstances.

Today, reaching the age of 40 in good health, with healthy lifestyle habits and greater body awareness, is increasingly common. For this reason, pregnancy in one’s forties is no longer an exception, but a fully integrated reality in modern society.

What is pregnancy like after 40?

From a medical perspective, pregnancy after the age of 40 is not radically different from pregnancy at younger ages. However, it does usually require closer medical monitoring. A woman’s body may respond differently to the hormonal and physiological changes associated with pregnancy, and certain parameters are typically monitored more closely from the early weeks.

Many women who become mothers at this age report feeling more fatigue, experiencing more noticeable changes in sleep patterns, or having slower recovery periods at certain stages of pregnancy. Even so, each experience is highly individual and depends more on overall health than on chronological age alone.

The body may also need more time to adapt to the changes of pregnancy. Muscles, the cardiovascular system, and metabolism respond differently than they do at 30. However, this does not prevent women from having a completely normal pregnancy.

Therefore, it cannot be said that pregnancy after 40 is inherently “worse.” The main difference relates more to ovarian reserve and egg quality, both of which decline progressively with age, especially after 35. This primarily affects the chances of becoming pregnant, rather than the development of the pregnancy itself once conception has occurred. In this regard, egg freezing before the age of 35, an increasingly common practice, can help women achieve pregnancy later in life using their own eggs.

It is also important to remember that being 40 today is not the same as it was decades ago. Women now reach this stage with better information, healthier lifestyles, improved medical care, and a more active role in their physical and emotional wellbeing. All of these factors positively influence pregnancy and its progression.

Mujeres maduras haciendo ejercicio

Are there more health risks?

It is important to clarify that age alone does not determine pregnancy risk. Women who are in good overall health, have no underlying medical conditions, and receive proper medical care do not necessarily face more complications than younger women.

After the age of 45, there may be a slightly increased risk of certain complications, which is why medical monitoring tends to be more individualized. Even so, each case should be evaluated individually, avoiding unnecessary generalizations.

When pregnancy does not occur naturally

Time plays a key role in fertility, especially for women. For this reason, if pregnancy does not occur after six months of trying, it is advisable to consult fertility specialists without delay. Assisted reproductive techniques can be essential allies in achieving pregnancy, with treatments tailored to each case. These may include ovarian stimulation treatments, in vitro fertilization (IVF), or egg donation when egg quality is insufficient to achieve pregnancy using one’s own eggs.

These options not only increase the chances of pregnancy but also allow treatments to be personalized and timelines to be optimized, which is particularly important at this stage of life.

Authors

Authors and medical review

Author
Dr. Elisa Pérez

Dr Elisa Pérez is Medical Director of IVF-Life Donostia and a gynaecologist specialising in assisted reproduction and reproductive medicine. Her clinical practice focuses on in vitro fertilisation (IVF), complex fertility cases, recurrent implantation failure and personalised fertility treatments. Alongside her clinical work, she is involved in research projects and scientific activities related to reproductive medicine. She is a member of SEF and SEGO.

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