It is possible for a 44-year-old to become pregnant, but the journey involves navigating significant biological and statistical challenges. The medical community defines pregnancy after age 35 as advanced maternal age (AMA), and at 44, this designation carries increased considerations. While many people in this age bracket successfully conceive and deliver healthy babies, the likelihood of both natural conception and live birth rates are markedly lower than in earlier reproductive years. Understanding the underlying biological factors and the medical options available is an important first step.
Fertility Statistics and Biological Decline at Age 44
The primary factor governing conception likelihood at 44 is the steep decline in both the quantity and quality of eggs. A person is born with all the eggs they will ever have, and the number of viable follicles declines sharply as they enter their early forties, a phenomenon sometimes described as the “fertility cliff.” By age 40, the monthly chance of natural pregnancy is estimated to be less than 5% per cycle, and this figure continues to drop significantly by age 44.
The most profound biological challenge is the dramatic decrease in egg quality, which means a higher rate of genetic abnormalities. This age-related deterioration affects the cellular machinery responsible for proper chromosome division. For a 44-year-old, approximately 90% of the eggs retrieved in an IVF cycle are expected to be aneuploid, meaning they have an abnormal number of chromosomes.
This high rate of aneuploidy directly contributes to the increased likelihood of early pregnancy loss. The risk of miscarriage increases substantially with age, with rates estimated to be well over 50% for women aged 45 and older. Consequently, even when conception does occur, the chance of carrying the pregnancy to term is significantly reduced due to these underlying chromosomal issues.
Assisted Reproductive Technology Options
Given the biological realities of egg quality and quantity at age 44, assisted reproductive technologies (ART) become a highly relevant option. The most common and effective method is In Vitro Fertilization (IVF), although success rates vary dramatically depending on the source of the eggs used. When using a patient’s own eggs, the live birth rate per IVF cycle is quite low, often reported to be in the low single digits, such as around 5% or less for those 43 to 44 years old.
For this age group, fertility specialists often recommend Preimplantation Genetic Testing for Aneuploidy (PGT-A). This process involves testing embryos created through IVF before transfer to identify those that are chromosomally normal (euploid). Transferring a euploid embryo, even in an older patient, offers a live birth rate similar to that of younger women, though finding a euploid embryo remains the significant hurdle due to the high rate of abnormal eggs.
The most successful ART option for a 44-year-old is the use of donor eggs from a younger individual. Since the egg’s age, not the recipient’s age, determines the genetic quality, donor eggs bypass the issue of age-related aneuploidy. The live birth success rate with donor eggs remains high, often exceeding 30% to 50% per transfer cycle.
Health Considerations for Mother and Baby
Pregnancy at age 44 is associated with a distinct set of increased health risks for both the mother and the developing fetus. The risk of developing pregnancy-related complications is higher, partly because older individuals are more likely to enter pregnancy with pre-existing conditions like hypertension or diabetes. Gestational hypertension, which can lead to preeclampsia, is a particular concern, with the risk being significantly higher for those aged 40 to 44 compared to younger mothers.
Other maternal risks include:
- A greater incidence of gestational diabetes, which requires careful management to prevent complications for both the mother and baby.
- Increased likelihood of placental issues, such as placenta previa.
- A higher chance of needing a Cesarean section delivery due to potential complications like labor dysfunction.
The overall risk of miscarriage is elevated, primarily due to the high probability of chromosomal abnormalities in the egg.
For the baby, the primary age-related risk is the increased chance of chromosomal abnormalities. For example, the risk of having a baby with Down syndrome rises exponentially with maternal age. Furthermore, the pregnancy carries an increased risk of preterm birth, which is delivery before 37 weeks, and low birth weight.
Essential Pre-Conception Screening
Before attempting conception, a comprehensive pre-conception evaluation is necessary to optimize health and assess reproductive potential. This process should begin with a consultation with a reproductive endocrinologist, particularly if a person over 40 has been trying to conceive for six months or more. The specialist can order specific tests to assess ovarian reserve, which is the remaining quantity of eggs.
Specific fertility tests include:
- The Anti-Müllerian Hormone (AMH) level, a blood test providing an estimate of the egg supply.
- Follicle-Stimulating Hormone (FSH) and Estradiol levels, typically measured on the third day of the menstrual cycle.
- A transvaginal ultrasound to determine the Antral Follicle Count (AFC).
These results offer a clearer picture of the remaining reproductive window and help guide decisions about treatment options.
General health screenings are equally important and focus on identifying any pre-existing conditions that could complicate a pregnancy. This includes checking blood pressure, screening for undiagnosed or poorly managed diabetes, and evaluating thyroid function. Addressing any chronic conditions and implementing healthy lifestyle changes, such as starting folic acid supplementation and optimizing nutrition, are necessary steps to create the best possible conditions for a successful pregnancy.