When Brigitte Nielsen announced she is pregnant with her fifth child at the age of 54, people immediately had questions. Did she conceive via assisted reproduction techniques? Is this pregnancy safe for her and the baby? How common is pregnancy over the age of 50? We asked a few doctors to weigh in on whether Nielsen's situation is at all unusual and about some of the practicalities of getting and being pregnant in your 50s.
Also, let's just get this out of the way at the beginning: Older men become fathers. All. The. Damn. Time. Mick Jagger, Steve Martin and George Clooney — there is no shortage of mature men becoming dads later in life. And for the most part, people seem OK with it despite the fact that there's evidence that children with fathers older than 45 are more likely to develop severe mental or developmental issues such as autism, schizophrenia and attention deficit disorders along with forms of dwarfism.
OK, back to Nielsen.
How common is pregnancy over the age of 50?
Let's start at the beginning. People born with a uterus and ovaries typically arrive with a fixed number of eggs and slowly use them up over the course of their lives until menopause is reached, Dr. Thomas A. Molinaro, a board-certified reproductive endocrinologist at Reproductive Medicine Associates of New Jersey (RMANJ), OB-GYN and clinical assistant professor for the department of obstetrics, gynecology and reproductive science at Rutgers Robert Wood Johnson Medical School, tells SheKnows.
"As women age, infertility and miscarriages become more common due to the diminishing quantity and quality of eggs," he explains.
According to Dr. Yen Tran, an OB-GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, California, pregnancy after the age of 50 was extremely rare before in-vitro fertilization. But now, reproductive developments like IVF, egg freezing and donor eggs are changing this, she tells SheKnows.
"Recent trends have shown that more women are postponing childbearing for the purpose of advancing their careers and pursuing education and other activities," Tran explains. "So by the time many women are deciding to have children, they can be at a very advanced maternity age."
And then there's menopause. According to Dr. G. Thomas Ruiz, an OB-GYN at MemorialCare Medical Group in Fountain Valley, California, the average age women enter menopause is 51, and it occurs because the ovaries have stopped functioning. In other words: Ovaries that don't function no longer produce eggs, so in order for pregnancy to occur, assisted reproductive technology would have to be utilized.
How does it work?
Thanks to ever-advancing reproductive technologies like IVF, egg freezing and egg donation, it's giving people more options for becoming pregnant later in life. Whether the egg comes from the same person who gestates the fetus (from prior egg freezing) or a new donor (or is the product of an unassisted conception), carrying a pregnancy at an advanced maternal age can be a little more difficult, Molinaro explains.
"These pregnancies are often considered high-risk, but with proper medical supervision can be very safe," he says. "It is essential that women over the age of 45 have a thorough evaluation prior to attempting pregnancy in order to ensure that they are healthy enough to carry a pregnancy."
What are the risks &/or benefits of pregnancy over the age of 50?
If someone gets pregnant naturally after age 42, there is a significantly higher risk of Down syndrome, Tran says. In addition, as pregnant people get older, there is also a higher chance of having gestational diabetes, preeclampsia, intrauterine growth restrictions and fetal demise, she adds. This has resulted in there being some stigma surrounding women at a more advanced age seeing a fertility specialist if getting pregnant naturally doesn't work out, Molinaro says.
However, Molinaro recommends that by the age of 35, people looking to get pregnant see a fertility specialist. "The quality and number of eggs change significantly after the age of 36, and there’s a higher chance of miscarriages," he explains. "If a couple doesn’t reach pregnancy after one year, they should seek special care."
The bottom line is that really, with our expanding reproductive technologies comes expanding reproductive choices, like delaying pregnancy. Is it the right choice for everyone? Probably not. Could there be complications? Yes, but that's the case with any pregnancy. But is it possible? Absolutely. And we wish Nielsen and her family all the best.