From the Guidelines
A 54-year-old woman can become pregnant, although it is extremely rare and often requires assisted reproductive technologies. According to the U.S. selected practice recommendations for contraceptive use, 2024 1, contraceptive protection is still needed for patients aged >44 years who want to avoid becoming pregnant, indicating that pregnancy is possible beyond the age of 44. The median age of menopause is approximately 51 years in North America, but it can vary from 40 to 60 years, and the median age of definitive loss of natural fertility is 41 years, ranging up to 51 years 1.
Pregnancy at an advanced maternal age, such as 54, carries significant risks, including maternal complications like hemorrhage, venous thromboembolism, and death, as well as fetal complications like spontaneous abortion, stillbirth, and congenital anomalies 1. The risks associated with continuing contraception, particularly risks for acute cardiovascular events or breast cancer, should also be considered. Key points to consider include:
- The incidence of venous thromboembolism is higher among oral contraceptive users aged 45–49 years compared with younger users 1
- The relative risk for myocardial infarction is higher among all oral contraceptive users than among nonusers, although the trend with increasing age is not demonstrated 1
- Small increased relative risks for breast cancer have been found among women aged ≥45 years whose last use of combined hormonal contraceptives was <5 years previously 1
Given these considerations, any 54-year-old considering pregnancy should consult with a reproductive endocrinologist and maternal-fetal medicine specialist for comprehensive evaluation and guidance regarding the significant medical risks involved. It is crucial for healthcare providers to weigh the risks of pregnancy against the risks of continuing contraception in women of advanced reproductive age.
From the Research
Pregnancy at 54 Years Old
- There is no direct evidence in the provided studies to suggest that a 54-year-old woman can or cannot become pregnant.
- The studies primarily focus on the importance of folic acid supplementation before and during pregnancy to prevent neural tube defects and other congenital anomalies 2, 3, 4, 5, 6.
- While the studies do not address the specific age of 54, they do emphasize the importance of preconception care and folic acid supplementation for women of reproductive age 3, 5.
- It is worth noting that pregnancy at 54 is extremely rare and would be considered a high-risk pregnancy due to the increased risk of chromosomal abnormalities and other complications.
- However, without direct evidence from the provided studies, it is not possible to make a definitive statement about the possibility of pregnancy at 54 years old.