Can I get pregnant naturally at 46?

Quick Answer

It is possible but very rare for a woman to get pregnant naturally at age 46. Less than 1% of pregnancies occur in women over age 45. The chances of conception decline sharply as women get older, primarily due to a decrease in the number and quality of eggs. While unusual, there are cases of women becoming pregnant without fertility treatments well into their 40s. Maintaining a healthy lifestyle can optimize fertility at any age.

What are the chances of getting pregnant naturally at 46?

The chances of getting pregnant naturally at age 46 are very low. Here are some key statistics:

– Less than 1% of pregnancies occur in women over 45 years old. The average age for menopause is 51.

– At 46, a woman’s ovarian reserve (number of eggs) has declined substantially. Women are born with about 1-2 million eggs but by puberty this drops to 300,000-500,000 eggs. By age 46, only about 3% of a woman’s eggs remain.

– Egg quality also declines significantly as women age, leading to higher rates of chromosomal abnormalities. At 46, over 90% of a woman’s eggs are abnormal, compared to only 20% at age 30.

– Each month, a 46-year old woman has about a 0.3-2.5% chance of conceiving naturally if having regular intercourse during her fertility window. This is quite low compared to the 20-25% monthly chance for a woman under 35.

– The odds of carrying a pregnancy to term are also lower. Over 50% of pregnancies in women over 45 result in miscarriage.

While the chances are low, natural conception in the mid-40s is still possible. But a woman’s fertility potential declines substantially between ages 45-50 as she approaches menopause.

What factors impact fertility at 46?

There are several key biological factors that affect a woman’s fertility in her mid-40s:

– **Fewer eggs remaining**: As mentioned earlier, at 46 a woman has only about 3% of her peak egg count remaining. With fewer eggs, the chances of one being released and fertilized each month is lower.

– **Egg quality declines**: Not only does egg quantity decrease, but the quality of the remaining eggs also declines. Chromosomal abnormalities become much more common, making conception less likely and miscarriage more likely.

– **Hormonal changes**: Levels of fertility hormones like estrogen and progesterone start to fluctuate irregularly in the years leading up to menopause. This can disrupt ovulation and make conceiving harder.

– **Reduced ovarian reserve**: The ovaries’ response to stimulation by fertility hormones decreases. The ovarian follicles (which contain the eggs) become less sensitive.

– **Thinner uterine lining**: The endometrium thins out over time, which can prevent implantation of a fertilized egg.

– **Higher risks**: Pregnancy at an advanced age is considered high-risk due to increased chances of complications like gestational diabetes, preeclampsia, miscarriage, stillbirth and genetic issues.

However, some women in their mid-40s still maintain a surprisingly robust ovarian reserve and good egg quality. Diet, lifestyle, genetics and other factors can influence fertility potential.

What lifestyle factors impact fertility at 46?

While biological factors are the main driver of age-related fertility decline, certain lifestyle factors also play a role. Women who want to optimize their natural conception chances in their mid-40s may want to consider:

– **Maintaining a healthy BMI**: Being significantly under or overweight can interfere with ovulation. A BMI in the normal range of 18.5-24.9 is ideal.

– **Quitting smoking**: Smoking depletes ovarian reserve faster and may trigger earlier menopause. It also reduces egg quality.

– **Minimizing alcohol intake**: Drinking heavily can disrupt ovulation and egg development. Moderate intake of 1-2 drinks per day is safer if trying to conceive.

– **Managing stress**: High long-term stress can hamper reproductive hormones. Practicing meditation, yoga, or other relaxation techniques may help.

– **Getting sufficient exercise**: Regular moderate exercise improves circulation to reproductive organs. But too much intense exercise could disrupt ovulation.

– **Eating nutritious foods**: Focus on getting plenty of fertility-boosting vitamins and antioxidants from fruits, vegetables, whole grains, lean proteins, nuts and seeds.

Making positive lifestyle adjustments can potentially help prolong fertility to some degree, although age remains the key factor. Maintaining healthy habits also improves overall wellness for mother and baby should conception occur.

When should I see a fertility specialist?

Most experts recommend seeing a reproductive endocrinologist or fertility specialist if:

– You are over 35 and have been trying to conceive naturally for 6 months without success.

– You have any known fertility issues like PCOS, endometriosis, prior miscarriages, etc.

– You have irregular menstrual cycles.

– You have a partner over age 50, as male fertility also declines with age.

– You want to explore options like egg freezing or IVF before your fertility potential declines further.

At 46, the chances of natural conception each month are low enough that seeing a fertility specialist right away is recommended. A specialist can run tests to assess ovarian reserve, egg quality, and whether assisted reproductive techniques may be beneficial.

Options like IVF with a donor egg from a younger woman have much higher success rates for women in their mid-40s. A specialist can help devise an appropriate treatment plan based on individual circumstances.

What tests may a fertility specialist run?

Fertility testing helps assess a woman’s ovarian reserve and identify any issues impacting conception. Common tests include:

– **Blood tests**: Levels of hormones like FSH, estrogen, and AMH indicate ovarian reserve status. Thyroid and prolactin levels are also evaluated.

– **Transvaginal ultrasound**: An ultrasound helps measure antral follicle count and provides an image of the reproductive organs.

– **HSG**: This x-ray test checks for structural problems in the uterus and fallopian tubes.

– **Laparoscopy**: This minor surgical procedure inspects the pelvic area for issues like endometriosis, scarring, or fibroids.

– **Hysteroscopy**: A camera is inserted vaginally to examine the uterine cavity for abnormalities.

– **SIS**: Saline is infused into the uterus through a thin catheter while performing an ultrasound to inspect uterine structure.

– **Semen analysis**: Testing a male partner’s semen helps determine if there are any sperm-related fertility issues.

After testing, a fertility specialist can offer guidance on the most suitable conception options based on each couple’s unique circumstances and preferences.

What are the options for getting pregnant at 46?

Below are some options women 46 and older may consider if hoping to conceive:

– **Timed intercourse**: Using ovulation prediction to pinpoint peak fertile days for intercourse. Less than 5% chance per cycle.

– **Fertility drugs**: Oral medications like Clomid or injectable hormones to stimulate ovulation. Success rates around 2-5%.

– **IUI**: Sperm is washed and directly inserted into the uterus around ovulation. Average success rate of 2-4% per cycle.

– **IVF with own eggs**: Eggs are retrieved and fertilized with sperm in a lab. Success depends greatly on egg quality.

– **Donor egg IVF**: IVF using eggs from a younger, healthy donor can have ~40-60% success rates.

– **Donor embryo**: An existing frozen embryo from another couple’s prior IVF cycle is transferred. Success around 40-50%.

– **Surrogacy**: The most complex option, but can have high success rates with donor eggs and another woman carrying the pregnancy.

Given low odds for most procedures with a woman’s own aging eggs, donor eggs offer the best chance for pregnancy through assisted reproductive technology. Thorough testing and counseling can help determine the most suitable options.

Are fertility treatments safe at 46?

Fertility treatments like IVF are generally considered safe for women 46 and older who are otherwise healthy, but some additional risks exist:

– **Pregnancy complications**: The natural risks of pregnancy in your mid-40s remain, like gestational diabetes, preeclampsia, and miscarriage.

– **Multiple pregnancy**: Some fertility treatments increase the odds of multiples like twins or triplets, which adds risks.

– **Ovarian hyperstimulation syndrome**: Injecting hormones to stimulate egg production can lead to a rare but serious complication. Milder symptoms like bloating and nausea are more common.

– **Emotional side effects**: The intense process can take a psychological toll; counseling resources should be offered by clinics.

– **Failures**: Even with treatment, success is not guaranteed due to age-related fertility decline. Managing expectations is important.

Undergoing treatments like IVF at 46 does not appear to pose any long-term health issues. But comprehensive screening and a full discussion of risks, benefits and alternatives is vital when deciding which options may be appropriate for your individual situation.

What are the success rates of IVF with own eggs at 46?

At 46, in vitro fertilization success rates using a woman’s own eggs are generally low. However, outcomes vary significantly based on the clinic, the woman’s individual ovarian reserve, whether fresh or frozen embryos are transferred, and other factors.

Here is an overview of average IVF success rates at 46:

– **Pregnancy rate per egg retrieval cycle**: Approximately 5-15%

– **Pregnancy rate per single frozen embryo transfer**: Around 3-7%

– **Live birth rate per cycle**: Only about 2-5% typically

After age 45, many clinics no longer recommend doing IVF with a patient’s own eggs given the low odds and high miscarriage rates. Instead, they advise using donor eggs from a younger woman.

With donor eggs, 46-year old women undergoing IVF have much more favorable success rates:

– **Pregnancy rates per transfer**: 50-60%

– **Live birth rates**: 40-50%

While challenging, a small percentage of women in their mid-40s do successfully conceive and deliver a healthy baby using their own eggs with IVF. But overall chances remain low due to inevitable age-related decline.

Should I consider using donor eggs?

Using donor eggs from a younger, healthy woman provides substantially higher odds of IVF success for women over age 45. With donor eggs, live birth rates per IVF cycle are often above 50% at age 46. This is much higher than the 5% or less success rate typically seen when using the patient’s own eggs.

There are some key considerations when deciding whether to pursue IVF with donor eggs:

– **Cost**: Donor egg IVF cycles cost $25,000 on average, with additional fees for the donor. Own egg IVF tends to cost $15,000 or less.

– **Wait times**: Finding an ideal donor match and coordinating cycles can take months. Use of frozen donor eggs shortens this process.

– **Genetics**: The child will not share your genetic material. However, you can select a donor who resembles your traits.

– **Disclosure**: You may struggle with the ethics of disclosure to the child about their biological origins.

– **Emotions**: The use of another woman’s eggs can bring up complex feelings like grief and jealousy during the process.

Guidance from a mental health professional skilled in third-party reproduction can help couples considering donor eggs work through the decision. For many, the greatly improved odds make it an optimal choice at advanced ages.

What should I know about using frozen donor eggs?

Frozen donor eggs offer several potential advantages compared to fresh donor eggs:

– **Shorter wait times**: Frozen eggs are often readily available, so you avoids months of coordination for an egg retrieval cycle.

– **Lower cost**: No need to synchronize a donor’s cycle with the recipient’s or pay for her ovarian stimulation. Overall costs may be $5,000-$10,000 less.

– **Donor screening completed**: The donor has already gone through the screening process prior to egg freezing.

– **Proven fertility**: Eggs that freeze and thaw well have demonstrated viability.

– **Higher volume**: 20-30 frozen eggs may be available from each donor, while a fresh cycle yields 10-15 eggs usually.

– **Flexibility**: Extra frozen donor eggs often remain for another transfer.

Success rates using frozen eggs are now equivalent to fresh eggs assuming the freeze/thaw process is handled properly. For women over 45, frozen donor eggs offer high pregnancy rates and shorter timeframes to consider.

How can I improve egg quality at 46?

While age is the primary determinant of egg quality, some lifestyle habits can help support egg health:

– **Take a prenatal vitamin** with folate and vitamin D to nurture eggs. CoQ10 may also benefit.

– **Reduce stress** through yoga, meditation, or other relaxation methods. High stress impairs egg maturation.

– **Achieve a healthy BMI** since being overweight or underweight can negatively impact egg quality.

– **Eat nutritious foods** full of antioxidants from fruits, veggies, whole grains, and healthy fats that provide nutrients eggs need to thrive.

– **Avoid BPA** found in some plastics by using glass or BPA-free containers and water bottles.

– **Limit alcohol** to 1-2 drinks per day max; heavy drinking can be toxic to eggs.

– **Stop smoking** since smoking depletes eggs and advances ovulation issues.

– **Moderate strenuous workouts** since intense exercise can sometimes disrupt ovulation.

While these measures may offer some benefit, they cannot overcome age-related egg quality decline. Using an egg donor provides a younger source of high quality eggs.

Is natural pregnancy possible at 46 without fertility treatments?

Natural conception leading to a live birth without any medical interventions is quite rare but still possible in exceptional cases for some 46-year old women. Key points:

– Typical odds of pregnancy each cycle at 46 range from 0.3% to 2.5% – much lower than for younger women but not zero.

– About 1 in every 100-200 women ages 45-49 achieves natural conception. But 80%+ result in miscarriage due to egg chromosomal issues.

– Women who do conceive naturally in their mid-40s often have a higher ovarian reserve and egg quality than average for their age.

– Factors like strong fertility history, no known issues, optimal health, regular cycles and a partner with good sperm health may increase the likelihood.

– Intercourse must be precisely timed during the fertile window to maximize chances.

– Even women with highly favorable odds only have 10-15% odds of carrying the pregnancy to term without miscarriage.

While an exceptional natural pregnancy can certainly occur, the odds are extremely long. Most 46-year olds wishing to attempt conception are best served by consulting a fertility specialist. But healthy living habits can help support fertility potential.


Age 46 marks a significant decline in female fertility due to depletion of ovarian reserve and egg quality as menopause approaches. However, natural conception remains possible in rare cases. Maintaining a healthy BMI, good nutrition, low stress levels, and optimal health supports fertility. Seeing a specialist right away for fertility testing allows creation of a customized conception plan with your options and chances based on your particular situation. Using an egg donor provides the highest success rates. While challenging, parenthood dreams can still come true for some women in their mid-40s. Open and compassionate discussion with your partner and doctor can help guide the decisions around your path to motherhood.

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