If 40 is the new 30, it's no wonder so many women are keeping up with all the activities from their third decade, including being able to conceive. Planned pregnancies among 40-year-olds are more prevalent than ever in the U.S.; the birth rate among women age 40 to 44 increased from 10.2 to 10.3 per 1,000 births in 2011, according to the Centers For Diseases Control and Prevention.
Despite how youthful forty-something women seem on the outside, there are certain biological realities they have to face. "It's harder to get pregnant at 40 and very hard after 45, but in the real world it does happen sometimes," says Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health at Boston IVF, and associate professor of obstetrics, gynecology, and reproductive Biology at Harvard Medical School. At age 40, you have about a 5 percent chance of becoming pregnant over the course of any given menstrual cycle, compared to a 20 percent chance for women under 30.
Regardless of the challenges, there are some smart steps you can take to make the most of your fertility after 40.
Get pre-conception counseling
It's a good idea for women of every age to map out a pregnancy plan with their doctors in advance. "Some medical conditions or medications can be detrimental to a future pregnancy. Also, learning about your family history may identify certain risks for a future offspring and undergoing genetic testing or seeing a genetic counselor should be done before you start trying," says Steven R. Bayer, M.D., a reproductive endocrinologist at Boston IVF fertility clinic in Boston, Massachusetts.
Cultivate expert timing
Conventional wisdom says that your best chances of getting pregnant are on days 12 to 14 of a standard 28-day menstrual cycle. That may not apply when you hit 40, though. "Women who approach 40 often start ovulating earlier and earlier in their cycle," says Alan Copperman, M.D., director of the Division of Reproductive Endocrinology and Infertility at Mount Sinai Medical Center in New York City and co-director of Reproductive Medicine Associates of New York. "It could be day 12, day 10, day 9, so they may not even be having sex at the right time."
To make sure your rhythm isn't off, track your menstrual cycle and figure out exactly when you're ovulating each month. Once you determine when your period is due, figuring out the timing of ovulation is actually easy. Simply count back 14 days before your next period is scheduled to start -- that's the day you're supposed to ovulate. You can double check when you're ovulating by using a basal body temperature chart, monitoring your cervical mucus, using an over-the-counter ovulation kit, or all of the above. When you've got it down, have sex every other day a few days before and after you're due to ovulate. "Sperm stays in your system for multiple days after you have intercourse and an egg stays in your system for a good five days after you ovulate," says Angela Chaudhari, M.D., a gynecologic surgeon and assistant professor at Northwestern University Feinberg School of Medicine in Chicago. "It's really a much longer window than you may think."
Double down on healthy habits
Although an impeccable facade may not reflect the state of your ovaries, it's critical to try to get your body into peak shape. "The older you are, the more you have to work at lifestyle stuff," says Jill Blakeway, a licensed acupuncturist, co-owner of The YinOva Center in New York City, and co-author of Making Babies: A Proven 3-Month Program for Maximum Fertility. "You can get away with being badly behaved at 22 and still get pregnant. Every egg isn't a winner when you're older, so that's the time to eat right and avoid caffeine and alcohol." Thirty minutes of cardiovascular exercise most days of the week is recommended, as is maintaining a healthy weight. Straying too far on either side of your ideal can mess with hormone function, cause estrogen levels to go out of whack, and impede your chances of conceiving.