It is possible, but rare, for a 65-year-old woman to get pregnant. While most women go through menopause in their late 40s or early 50s, some may still ovulate and have menstrual periods into their 60s. However, fertility declines sharply with age. Here’s an overview of pregnancy potential after age 65.
What affects fertility at 65?
There are several age-related factors that make getting pregnant difficult for women over 65:
- Lower number of eggs – Women are born with all the eggs they will ever have. The number of eggs declines steadily with age. By age 65, the remaining eggs are more likely to have chromosomal abnormalities.
- Lower egg quality – Eggs that manage to be ovulated and fertilized often fail to implant or miscarry more frequently.
- Irregular periods – The menstrual cycle becomes more irregular leading up to menopause, making ovulation less predictable.
- Thinner uterine lining – The uterine lining may not be able to support embryo implantation and development.
- Underlying health issues – Chronic medical conditions like hypertension, diabetes, and cardiovascular disease become more common with advanced age.
What are the odds of getting pregnant at 65?
There are very few well-conducted studies looking at natural conception rates in women over 60. Here is what the available research shows:
- One study found that for women aged 60-63, the chance of conception was around 1% per menstrual cycle.
- Another study found that women aged 63-68 had around a 0.16% chance of conceiving per cycle.
- Case reports describe rare natural pregnancies resulting in live births in women aged 63-70.
While pregnancy over 65 is possible, the odds of success appear to be less than 1% per menstrual cycle even in the early 60s. The chances continue to decline as women get closer to menopause.
What risks are involved?
Pregnancy after 65 carries significant health risks including:
- Miscarriage – The risk of miscarriage rises from around 15% at age 35 to over 50% by the mid-40s. The risk likely approaches 90% for women over 65.
- Gestational diabetes – Older women have a higher rate of diabetes during pregnancy.
- Preeclampsia – Older women have increased rates of high blood pressure and protein in the urine during pregnancy.
- Placental problems – Conditions like placental abruption and placenta previa are more common.
- Preterm birth – Older women have higher rates of premature delivery.
- Low birth weight – Babies of older mothers are more likely to be born small.
- Chromosomal issues – The risk of Down Syndrome rises from 1 in 1250 at age 35 to 1 in 100 by age 45.
- Maternal mortality – Pregnancy-related death is 6-7 times more common in women over 45 compared to those under 35.
In addition to pregnancy complications, the physical demands of late pregnancy and delivery can be very taxing for a woman over 65.
What about using donor eggs?
Using donated eggs from a younger woman can increase the chances of conception for a woman over 65. With in vitro fertilization (IVF), the donor eggs are fertilized with the partner’s sperm and transferred to the uterus of the older woman who intends to carry the pregnancy.
Some key points about using donor eggs after 65:
- Success rates are still lower than donor egg IVF in younger women, but can reach over 50% per transfer in some studies.
- Uterine receptivity and risks from underlying health issues may still pose challenges.
- Hormone treatment used to prepare the uterine lining could have risks at this age.
- There are ethical concerns due to extremely advanced maternal age and questions of fairness in the organ transplant process if complications occur.
For women using their own eggs, natural conception over 65 remains unlikely. But with donor eggs, pregnancy is possible though still higher risk. Extensive counseling and strict screening are advised before attempting pregnancy at this age via any method.
The bottom line
While women have conceived naturally in their 60s and beyond, it is extremely rare. The chances decline dramatically after age 45. Any pregnancy at age 65 or older carries major health risks.
Women pursuing motherhood in their 60s or beyond should understand the low odds of success, high complication rates, and ethics of extreme age-related infertility treatment. Counseling and medical screening are imperative when considering pregnancy at such an advanced age.