How old is too old to have a child?

With news of 60+ year olds having babies, it seems as if there is really no limit to the age of having a child.  The implication of this question is as follows:

  1. What is the oldest age a woman can get pregnant?
  2. What are the difficulties older women encounter in pregnancy?
  3. Are the babies going to be normal?

There is no definitive rule as to the oldest age for a woman to get pregnant.  Generally speaking, fertility declines after 35 and falls sharply after 40.  From personal experience, the oldest pregnant women Dr. Wang has cared for are 46 years old.  Importantly, they have all had children in the past conceived naturally (not by IVF) and the pregnancies they had at 46 were all natural pregnancies.  Of interest, all of them had perfectly healthy babies.

For Dr. Wang’s infertility patients, the oldest women getting pregnant with their own eggs were 46 but unfortunately they ended up miscarrying.  So far, in Dr. Wang’s experience, the oldest IVF patients succeeding having babies were 44 (when they got pregnant with their own eggs).

The medical difficulties women over 40 would face are multiple.  As indicated, the fertility of a woman ≥ 40 is drastically reduced.  Even after she gets pregnant, the miscarriage rate is significantly higher.  For example, a 40 year old has almost 50% chance of a miscarriage compared with 15-20% for the general population.

The chances of medical complications are also increased: the common ones are “pregnancy induced hypertension” and “pregnancy related diabetes”.  It is generally felt that “older” women do not labour (poor contractions or “posterior” positions are examples) as well as younger women.  As a result of these reasons, they are more likely to undergo C-sections.

The chance of a baby having a chromosomal abnormality (a major genetic problem) is about 1/100 for a 40 year-old woman and about 1/250-300 for a 35 year-old woman.  Although the chance of genetic disorder is higher, 1/100 means that most babies are perfectly healthy.  There are antenatal tests that can be undertaken to assess these risks and abnormalities.

It is beyond the scope of this space to discuss the social and psychological adaptation of having children late in life (or at any time in life, for that matter).

Posted in: Common Queries Regarding Fertility