Having a baby after the age of 40 is no longer uncommon. According to the Centers for Disease Control and Prevention (CDC), the rate of first-time births among women aged 40 to 44 has increased more than fourfold between 1985 to 2012.1 With the fertility treatments available today, it is no wonder that women feel empowered to start a family when the time is right for them. Here is a list of a few of the options available today:
• Infertility treatments, such as IVF (in-vitro fertilization)
• Freezing eggs
• Sperm banks
• Surrogacy
Even with all of the fertility option treatments available, a woman’s fertility rate does significantly decline after the age of 35. It may be hard to imagine, but after 35, a woman is considered “advanced maternal age.” There are several risk factors for infertility after age 35:
• Decreased number of eggs
• Unhealthy eggs
• Ovaries cannot release eggs properly
• Increased risk of miscarriage
• Higher chances of health conditions that can impede fertility
This means that even though a woman may feel like she is in the prime of her life, conception may take longer than anticipated. Further, there is a higher risk for miscarriage, as well as pregnancy and delivery complications.
The good news is that many women can conceive and deliver healthy babies even after 35 and well into their 40s. Eating a nutritious diet and making healthy lifestyle choices, such as not smoking, reducing or not drinking alcohol, maintaining a healthy weight, exercising and managing stress patterns is essential.2 While there is no official guidance for good nutritional habits while seeking pregnancy after 35 and beyond, research shows that good food choices are key for a successful pregnancy and delivery.3 There are a few specific nutrients that can help support women’s reproductive health:
Vitamin D
Vitamin D is an essential fat-soluble nutrient. In literature, it has been found that women may be less likely to conceive if vitamin D intake is below recommended levels or if serum 25-hydroxyvitamin D levels are inadequate or deficient (i.e., <20 ng/mL).4 Vitamin D deficiency has been linked to conditions that decrease fertility, such as polycystic ovary syndrome (PCOS).5 Vitamin D levels may also predict IVF outcomes, as they have been associated with a greater chance of clinical pregnancy after fertility treatment.6 For women looking to conceive who have vitamin D deficiency, it might be beneficial to increase vitamin D intake to adequate levels.
Folate
Folate and folic acid are members of the B complex family. These water-soluble nutrients are important for oocyte quality, maturation, fertilization and implantation.7 The literature shows that higher serum folate levels may also benefit fertilization and oocyte counts for women undergoing infertility treatment.7 In fact, in women undergoing IVF, folic acid supplementation was linked to a 3.3 times greater chance of becoming pregnant.8 Plus, adequate folic acid intake helps reduce the chance of neural tube defects during pregnancy. For women looking to conceive, folate and folic acid supplementation are considered standard recommendations, at no less than 400 mcg per day for good health.
L-Carnitine
L-carnitine is an amino acid-like nutrient that helps the body turn fat into energy. L-carnitine supplementation in women with PCOS has been shown to improve the quality of ovulation and successful pregnancy significantly.9 Other studies have found that both L-carnitine and acetyl L-carnitine may improve gonadotropins and sex hormone levels, improving oocyte health.10
DHA (Docosahexaenoic Acid)
Consumption of DHA fatty acids has been shown to help increase progesterone levels, which is essential in pregnancy, potentially helping to delay ovarian aging and improving oocyte quality in women after 35.11 DHA is well known to also benefit baby by supporting brain and eye development. In fact, the March of Dimes, American Academy of Pediatrics, and the Food and Agriculture Organization of the United Nations agree that pregnant and lactating women should have a minimal intake of 200–300 mg of DHA daily.12
DHEA (Dehydroepiandrosterone)
DHEA is an androgen produced in the adrenal glands and ovaries and is converted to estradiol and testosterone. The role of DHEA in reproduction and diminished ovarian reserve has been reviewed.13 DHEA supplementation has been reported to help reduce the miscarriage rate in women of all ages, but its performance was more pronounced in those aged 35 and older.14 Further, in a systematic review and meta-analysis, DHEA supplementation improved ovarian reserves and IVF/ICSI outcomes in patients with poor ovarian reserve.15
Coenzyme Q10 (CoQ10)
CoQ10 is a fat-soluble, vitamin-like nutrient that maintains cells via its antioxidant properties. CoQ10 has been studied for its effects on ovarian response and embryo quality. It was found to significantly increase the number of oocytes retrieved, increase fertilization rate by 67.49 percent, and produce more high-quality embryos.16
With that, when it comes to fertility and prenatal health, it is never too soon or too late to take the utmost care of your baby’s first home—you! VR
References:
1 First Births to Older Women Continue to Rise. Centers for Disease Control and Prevention website. www.cdc.gov/nchs/products/databriefs/db152.htm (Links to external site). Published May 2014. Accessed April 25, 2021.
2 Infertility FAQs. Centers for Disease Control and Prevention website. www.cdc.gov/reproductivehealth/infertility/index.htm#:~:text=Yes.,to%20term%20(impaired%20fecundity) (Links to external site). Last Reviewed April 13, 2021. Accessed April 21, 2021.
3 Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol. 2018;218(4):379-389. doi:10.1016/j.ajog.2017.08.010.
4 Jukic AMZ, Baird DD, Weinberg CR, Wilcox AJ, McConnaughey DR, Steiner AZ. Pre-conception 25-hydroxyvitamin D (25(OH)D) and fecundability. Hum Reprod. 2019;34(11):2163-2172. doi:10.1093/humrep/dez170.
5 Thomson RL, Spedding S, Buckley JD. Vitamin D in the aetiology and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2012;77(3):343-350. doi:10.1111/j.1365-2265.2012.04434.x.
6 Garbedian K, Boggild M, Moody J, Liu KE. Effect of vitamin D status on clinical pregnancy rates following in vitro fertilization. C Open. 2013;1(2):E77-E82. doi:10.9778/cmajo.20120032.
7 Schaefer E, Nock D. The impact of preconceptional multiple-micronutrient supplementation on female fertility. Clin Med Insights Women’s Heal. 2019;12:1179562X1984386. doi:10.1177/1179562×19843868.
8 Boxmeer JC, Macklon NS, Lindemans J, et al. IVF outcomes are associated with biomarkers of the homocysteine pathway in monofollicular fluid. Hum Reprod. 2009;24(5):1059-1066. doi:10.1093/humrep/dep009.
9 Ismail AM, Hamed AH, Saso S, Thabet HH. Adding L-carnitine to clomiphene resistant PCOS women improves the quality of ovulation and the pregnancy rate. A randomized clinical trial. Eur J ObstetGynecolReprod Biol. 2014;180:148–52.
10 Agarwal A, Sengupta P, Durairajanayagam D. Role of L-carnitine in female infertility. Reprod Biol Endocrinol. 2018;16(1):5. Published 2018 Jan 26. doi:10.1186/s12958-018-0323-4.
11 Nehra D, Le HD, Fallon EM, et al. Prolonging the female reproductive lifespan and improving egg quality with dietary omega-3 fatty acids. Aging Cell. 2012;11(6):1046–1054. doi:10.1111/acel.12006.
12 Smith SL, Rouse CA. Docosahexaenoic acid and the preterm infant. Matern Heal Neonatol Perinatol. 2017;3(1):1-8. doi:10.1186/s40748-017-0061-1
13 Fouany MR, Sharara FI. Is there a role for DHEA supplementation in women with diminished ovarian reserve? J Assist Reprod Genet. 2013;30(9):1239–1244. doi:10.1007/s10815-013-0018-x.
14 Gleicher, N., Ryan, E., Weghofer, A. et al. Miscarriage rates after dehydroepiandrosterone (DHEA) supplementation in women with diminished ovarian reserve: a case control study. Reprod Biol Endocrinol. 2009;7(108). doi:10.1186/1477-7827-7-108.
15 Zhang M, Niu W, Wang Y, et al. Dehydroepiandrosterone treatment in women with poor ovarian response undergoing IVF or ICSI: a systematic review and meta-analysis. J Assist Reprod Genet. 2016;33(8):981–991. doi:10.1007/s10815-016-0713-5.
16 Xu Y, Nisenblat V, Lu C, et al. Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled trial. Reprod Biol Endocrinol. 2018;16(1):29. doi:10.1186/s12958-018-0343-0.
Trisha Sugarek MacDonald holds a Master of Science in nutrition and is also working toward a doctorate in nutrition from Texas Woman’s University. MacDonald has nearly a decade and a half of experience in nutraceutical manufacturing and is currently the senior director of research & development as well as the national educator at Bluebonnet Nutrition, Sugar Land, TX, where she investigates new ingredients, directs the launch of new products, and provides industry training on numerous subjects as they relate to the connection between nutrition and health. She is a frequent editorial contributor and lecturer on the benefits surrounding the responsible use of supplements. For more information, call (800) 580-8866.
