From the Guidelines
The oldest age for female pregnancy is not precisely defined, but women can still become pregnant until menopause or around age 50-55 years.
Key Points
- The median age of menopause is approximately 51 years in North America, but can vary from 40 to 60 years 1.
- The median age of definitive loss of natural fertility is 41 years, but can range up to 51 years 1.
- No reliable laboratory tests are available to confirm definitive loss of fertility in a woman, and assessment of follicle-stimulating hormone levels may not be accurate 1.
- Pregnancies among women of advanced reproductive age are at higher risk for maternal complications (e.g., hemorrhage, venous thromboembolism, and death) and fetal complications (e.g., spontaneous abortion, stillbirth, and congenital anomalies) 1.
- Women aged >44 years still need contraceptive protection if they want to avoid pregnancy, according to the American College of Obstetricians and Gynecologists and the North American Menopause Society 1.
Considerations
- Health-care providers should consider the risks for becoming pregnant in a woman of advanced reproductive age, as well as any risks of continuing contraception until menopause 1.
- The risks associated with continuing contraception, such as acute cardiovascular events (venous thromboembolism, myocardial infarction, or stroke) or breast cancer, should also be considered 1.
From the Research
Oldest Age for Female Pregnancy
The oldest reported age for a female pregnancy is 63 years, as documented in a case study published in 1997 2. This pregnancy was achieved through oocyte donation and resulted in the birth of a healthy female infant.
Pregnancy Risks at Advanced Maternal Age
Pregnancies at advanced maternal age (over 35 years) are associated with increased risks of complications, including:
- Spontaneous miscarriage
- Preterm labor
- Gestational diabetes mellitus
- Pre-eclampsia
- Stillbirth
- Chromosomal abnormalities
- Cesarean delivery 3 Women over 45 years old are also at higher risk of pregnancy complications, and should receive thorough preconception evaluation and counseling about their specific risks 4.
Fertility and Pregnancy Outcomes at Advanced Maternal Age
Fertility declines with age, and women over 35 years old are considered to be of advanced maternal age 5. However, with the help of assisted reproductive technologies, pregnancy is possible for women in their 40s and beyond. A study published in 2012 found that women aged 43 years or older had higher rates of cesarean and preterm delivery compared to women aged 25-35 years 6.