Conceiving Naturally Over 40: An Essential Guide to Optimizing Fertility
Medically Reviewed by Dr. Ivy Branin Naturopathic Doctor at Simplicity Health Associates.
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As a naturopathic doctor specializing in Women’s Health and Hormones, one of the common questions I get from women is about trying to conceive in their 40s. It can be a confusing and often discouraging journey—is it still possible to get pregnant naturally, or are there limitations due to age? In this post, I'm going to be talking all about trying to conceive when you are over 40 and looking at a natural protocol.
Any of the supplement recommendations I'll be mentioning will be available through my online dispensary, FullScript. If it's your first supplement order with FullScript, you'll receive 10% off!
Understanding Fertility Over 40
Let's dive into understanding more about fertility over 40. The reality is that as we age, the number of eggs we have decreases, and their quality can also go down.
Some quick stats from ACOG (the American College of Obstetricians and Gynecologists) illustrate this:
In utero: We are born with about 1 to 2 million eggs, in a kind of suspended animation, awaiting puberty.
At puberty: That number goes down to about 300,000 to 500,000.
By age 37: That number of eggs is now around 25,000.
Around age 51: That number goes down to about 1,000.
So, unfortunately, the number of eggs does decrease. Then there's quality. We're talking about the number of chromosomally normal eggs, and these will be decreasing due to the oxidative stress of aging. In women over the age of 40, about 2-10% of eggs are considered chromosomally normal. For women under 30, that percentage is around 48%.
Now, you might be thinking, "Okay, this sounds grim—decreased eggs, decreased egg quality." Well, actually, there's a crucial window of opportunity!
Approximately four months prior to ovulation, a small pool of immature eggs begins to grow. Some of these will naturally die off, leaving one egg that will eventually mature, be ovulated, and potentially be fertilized, leading to a pregnancy.
That four-month period is actually where most of the damage happens, and this has nothing to do with age at all. There's this limiting belief that nothing can be done with egg quality as we mature, but actually, there is a lot you can do, specifically in that four-month window. It's important to remember that timeframe!
Challenges and Risks of Conceiving Over 40
The biggest challenges are specifically a reduction in eggs and potentially poor egg quality. Some of the higher risks associated with getting pregnant in your 40s include:
Increased risk of miscarriage
Preeclampsia (a type of high blood pressure associated with pregnancy)
Small gestational size (affecting the fetus)
Increased risk of C-section
However, I would say that a lot of the things we recommend as naturopaths can help support fertility and also provide very proper preconception and pregnancy care, which can significantly reduce the risks of some of these occurrences.
Interested in learning more about what to expect when being pregnant in your 40’s? Consider reading this blog post.
Support and Increase Egg Quality
I highly recommend starting the protocol of supplementation, lifestyle changes and diet at least four months prior to trying to conceive because we want to optimize egg quality during that critical four-month period. Here are some specific supplements I typically recommend for egg quality and general fertility:
High-Quality Multivitamin
Look for one with methylated folate. Folate is very important, especially methylated folate, because many people do not naturally activate standard folic acid. Also ensure it contains important nutrients like iodine, zinc, iron, and vitamin D. Optimizing folate levels is crucial even before trying to get pregnant.
Omegas (DHA-rich)
Whether from fish oil or vegan algae sources, you want it to be high in DHA, as this supports baby's brain development.
N-Acetylcysteine (NAC)
Now we're talking about nutrients very specific for egg quality. NAC is a strong antioxidant and a precursor for glutathione, which is very important for egg quality and ovulation, especially in cases of PCOS (Polycystic Ovarian Syndrome).
CoQ10 (Ubiquinol)
Ubiquinol is the more bioavailable form of CoQ10, and this is what I recommend in my practice. It's another strong antioxidant, vital for mitochondrial health. Mitochondria are the energy houses of the cells, and their health is crucial for healthy eggs.
Resveratrol
Found in red grapes, cherries, and even chocolate, resveratrol is a very strong antioxidant. Many studies show it protects eggs (also known as oocytes) by decreasing reactive oxygen species, which are responsible for oxidative stress that damages cells.
NMN (Nicotinamide Mononucleotide)
This is an important co-factor for increasing NAD+, one of the energy-producing agents of the mitochondria, and can really help support egg quality.
Click Here to Learn More and Purchase Dr Ivy’s Recommended Fertility after 40 Supplement Protocol.
Nutrition and Lifestyle Protocols
These are beneficial at any age when trying to get pregnant, but especially in your 40s.
Reduce/Eliminate Alcohol: Alcohol creates a lot of oxidative stress and is a mitochondrial toxin, which will not support your fertility journey.
Reduce Refined Sugars and Carbohydrates: These can interfere with ovulation.
Adopt a Mediterranean Diet: This diet emphasizes fish, olive oil, whole grains, and lots of vegetables and fruits. It's probably one of the most studied diets when it comes to fertility because it helps with maintaining a healthy weight, proper lipid levels (cholesterol), insulin, and blood sugar levels. Most importantly, it's very high in antioxidants and folate.
Movement: Get enough exercise, but also listen to your body. It's generally best to do higher-impact exercise earlier in the day due to cortisol levels.
Stress Management: This is incredibly important. Have stress management techniques in place, whether that's journaling, exercising, dancing, meditation, or working with a therapist.
Avoid Endocrine Disruptors: This should probably be at the forefront! Eliminate and avoid as much plastic use as possible. Also, choose household and personal care products that are free of chemicals known as endocrine disruptors and xenoestrogens.
Interested in learning more about boosting male fertility? Consider reading this blog post.
Your Holistic Roadmap to Success Over 40
What does an overall holistic approach for optimizing success look like, specifically if you're over 40 and wanting to try to get pregnant?
I would say you really want to first start off with at least a 2 - 4 week detoxification protocol. I call this "step zero." I do have some resources that outline more about what that looks like, which is actually a good segue to announce that we will be launching a comprehensive "Getting Pregnant in Your 40s" e-course very soon!
Detoxification prior to even beginning your major preconception journey is essential. After detoxification, everything that I've mentioned you would want to be starting at least four months prior to conception. Again, that's that big window where a lot of oxidative stress could be happening.
So, this means:
0. Detoxification
1. Starting your supplements for egg quality.
2. Adopting the Mediterranean diet, adapted to your nutritional needs and food preferences.
3. Implementing a good stress management and self-care system.
A Personalized Plan for Your Fertility Journey
While Fullscript is a powerful tool for sourcing high-quality supplements, the most effective care for your fertility journey comes from a plan tailored specifically to your unique health needs.If you have any questions about your preconception health, especially if you have pre-existing health concerns, a consultation with a naturopathic doctor is a crucial first step. We can help you navigate a safe, effective protocol that ensures you are getting the right support for your fertility journey.
At Simplicity Health Associates, both myself, Dr. Ivy Branin, and Dr. Pauline Hoang are dedicated to providing personalized care. We will work with you to understand your unique health picture and build a supplement and lifestyle regimen that supports your specific needs, giving you peace of mind.
Frequently Asked Questions
How long will it take to improve my egg quality?
We focus on a four-month preconception window because that's the length of time it takes for a small group of immature eggs to mature and prepare for ovulation. By implementing a natural protocol of diet, lifestyle, and supplements for at least four months, you can significantly improve the health and quality of the egg you will ovulate.
Is it okay to do a detox while trying to conceive?
No, you should never detox while actively trying to conceive or during pregnancy. We recommend a gentle two to four-week detoxification protocol as a "step zero" at least one month before you begin your four-month preconception journey. This helps to prepare your body and reduce oxidative stress.
Is the Mediterranean diet the only option?
The Mediterranean diet is one of the most well-studied for fertility and is highly recommended due to its anti-inflammatory and antioxidant properties. However, any diet that emphasizes whole foods, healthy fats, and antioxidants while reducing refined sugars and processed foods can be beneficial. It's important to adapt a dietary protocol to your personal nutritional needs and preferences.
Can stress really impact my fertility?
Yes, absolutely. Chronic stress elevates cortisol, which can interfere with the hormones needed for ovulation and can create a lot of oxidative stress in the body. Implementing stress management techniques like meditation, yoga, or journaling is a critical part of any natural fertility protocol.
Book An Appointment
If you're concerned about remaining healthy, or may suspect that there is an underlying health concern, our team at Simplicity Health Associates are dedicated to helping you navigate this journey through personalized, holistic treatment plans.
About Dr Ivy Branin
Dr Ivy Branin is a Naturopathic Doctor in NYC who received her degree in Naturopathic Medicine from Bastyr University. She graduated with a bachelor’s degree in biochemical engineering and a minor in French from Rutgers University. After graduating from Rutgers, she worked for 3 years as a process validation engineer in the pharmaceutical industry in New York and Connecticut.
As a naturopathic doctor in NYC, Dr Branin does not approach disease with a “one-size fits all” perspective but rather sees each patient as an individual with their own potential for optimal health. She supports people in their desire to feel good and good about themselves using the naturopathic principles of dietary and lifestyle management, homeopathy, visceral manipulation, botanical medicine, and craniosacral therapy.