Making the decision to have children can be challenging. Status of relationships, careers, finances, living situations, etc. all come into play…and then there’s biology. Can you even get pregnant? Should you get pregnant? Mothers have been giving birth at older ages than previous generations, having their first child at an average age of 26. The average age was 21 almost 45 years ago.1 Is this wise? We have also seen increases in the number of children born with autism, Down Syndrome, and other congenital defects, which could be related to the mother’s age. So, what’s the scoop? What actually happens that makes women better for pregnancy at some ages rather than others? Is there an ideal age to get pregnant? Let’s explore, shall we?
We begin at the beginning: female reproductive development—the parts that apply to actually getting pregnant, at least.
Puberty
Puberty begins around the age 9-10 and, on average, lasts four and half years. Surprised? I too thought puberty was at first menstruation, however, it is actually in the years leading up to that: when growth spurts, new body hair and sweat glands, and breast growth occur. The first menstrual period is actually toward the end of puberty.2,3,4
Fertility
The first menstrual period does not necessarily mark the beginning of a woman’s fertility. Although her body is now capable of creating a suitable environment to grow a fetus, as well as providing an ovum for half of that fetus’ DNA, most females do not ovulate until about a year of menstruating.2 At that point, regular ovulation (release of an egg from the ovary) begins and a woman can get pregnant. A woman remains fertile typically until her early fifties, when menopause begins, and ovulation becomes irregular before stopping all together.
Strictly biologically speaking, the female body is most fertile and in the best position to carry and deliver a child in her 20s. Women reach their fertile peak in their 20s, and are less likely to have health complications such as hypertension or gestational diabetes.5,6,7 There is also less of a chance of miscarriages or other complications during delivery. For the baby, there is a lower risk of chromosomal abnormalities and other complications when the mother is in her 20s.7
This is not to say that getting pregnant at any other age will be markedly more challenging; research has simply found early twenties to be ideal. Here are the numbers5,8:
| Age | Risk of Infertility | Risk of Miscarriage |
| 20s | 6% (early) | 10% |
| 9% (late) | ||
| 30s | 15% (early) | 12% (early) |
| 30% (late) | 18% (late) | |
| 40s | 64% (early) | 34% (early) |
| No data for late 40s | 58% (late) |
So really, women do not have a whole lot to worry about until late 30s and beyond. Let’s look at what’s behind some of these numbers for this age group.
Geriatric pregnancy
Women who conceive after the age of 35 are considered “geriatric pregnancies.” This is because at the age of 35, fertility begins to drastically decrease despite normal ovulation and menstruation.8 There are many changes that occur in the egg cells, uterus, and hormones that cause this decrease in fertility. Research has found that there are greater chances of finding abnormalities in the microtubules and chromatin (cell structures) of the ova of women over 40 years old. These abnormalities can lead to spontaneous abortion and other complications.8 The uterus also decreases in functionality, which could cause problems with implantation or dysfunctional labor. Hormonally, women become less responsive to gonadotropins, which means that they have a lower number of follicles in their ovaries that are capable of maturing into an egg for release.8
Again, it is not impossible to become pregnant after 35, it is simply less common, and there are more risks to consider. For example, women in their mid-thirties and older are at a higher risk of high blood pressure and gestational diabetes. Along with that, comes an increased risk of miscarriage and complications due to uterine fibroids.5 As stated previously, there is an increased rate of conceiving a child with Down Syndrome: 1/900 at age 30-39 and 1/100 at age 40+.5
Other factors
Along with physiological circumstances, there are other considerations to make when deciding the best age to get pregnant, including finances, relationships, and career. Many women are in debt from education expenses in their twenties, and sometimes even into their early thirties. Also, younger couples tend to have less money saved away for home, baby, and retirement.7 Ensuring that there is a structure in place to provide the time and care necessary to child and self without shirking financial obligations is no easy task.
This can usually be handled in the context of relationships by creating partnerships and support systems with loved ones, and those relationships should also be considered in the decision to get pregnant. The stability of the partnership, the age and support of future-grandparents, where friends are at in their lives and how everyone can be supported.7
To go along with financials, most twenty-year-olds do not have the job stability or accrued maternity days to have a baby without taking a financial hit. Some women prefer to develop their career before having children, and depending on their goals, that could be quite a long time.5 At this point, you are probably thinking there are only two options: work or be a mom. Not necessarily! There are always opportunities to be creative in childcare, work hours, and utilizing support systems to have a workable life.
Wait…What About Men?
Men’s fertility also declines with age, although much later in life. Their decline starts around age 60. While they will still be able to produce viable sperm, they are more likely to have genetic abnormalities than younger men.6 Research has shown that the age of the female contribution to the child is much more influential, particularly in couples having children between 20-40 years old.8
You have the facts: women peak biologically in their early 20s, and drastically decline after 35. Women in their twenties may not be in a stable life situation to care for a child, while women with well-established careers tend to have more financial flexibility and maturity. There are risks and benefits to having children at different ages, some biological, some with regard to lifestyle. An important note is that age is not the single factor that determines the health of your baby. Diet, exercise, prescription or illicit drug use, medical conditions, and a host of other factors can play into your pregnancy and the health of both you and your child. Talking to your partner, and to your doctor, about reproducing is a great way to get clear on your circumstances, options, and preferences.
Many couples struggle with infertility, and find solutions with IVF, egg/sperm donors, or adoption. Other women consider freezing their own ova in their twenties in order to use them when they are ready to start a family. There is a lot that goes into producing a child; from the miracle of conception all the way to labor and delivery. I hope this article provided a jumping off point for conversation around your family planning and wish you the best!
