Even before many families decided to put off having children because of the COVID-19 pandemic, birth rates in the US have been declining steadily in the last decade. However, this overall decline of birth rates is more nuanced when we look at what’s happening to women in different age groups. CDC’s data shows that birth rates have been declining for women in their teens to early 30s, women in their late 30s and 40s are actually seeing a more or less steady increase in birth rates since at least 2005. In fact, births among women 40-44 have been steadily increasing for over 30 years.
It’s not hard to see why: Many of us start our careers in fields and roles that demand – rightfully or not – far more from us than would allow for raising children. We spend more time finding the right partners. Many feel socially and economically more prepared for a parenthood in their 40s.
However, women in their 40s do face particular challenges when it comes to reproductive health. Studies show that it becomes progressively harder for women to get pregnant after about age 35, and once pregnant, complications become more common with age. As high-achieving planners, many women who pursue a pregnancy in their 40s do everything they can to prepare for a healthy pregnancy.
Here are four supplement-focused recommendations specifically for women who are coming to the journey later in life.
1. Prenatal vitamins, minerals and antioxidants
OBGYN doctors recommend prenatal vitamins to every woman planning to get pregnant or actively trying (in addition to women who are already pregnant or nursing). Here are a few important prenatal nutrients:
- Folate: It’s the B vitamin that supports healthy development of the baby’s brain.
- Vitamin B12 and B6: These two other B vitamins are for the preconception period. A few studies suggest a possible correlation between consistent intake of these two B vitamins and normal ovulation and conception.
- Zinc, selenium, iodine: Although many minerals support reproductive health, zinc, selenium, and iodine are especially important for optimal thyroid function. The thyroid plays a surprisingly broad role in female fertility, influencing everything from hormone balance and egg maturation to the thickening of the endometrium.
- Antioxidants: “Although ovarian follicles naturally contain a whole host of antioxidant vitamins and enzymes, these are often diminished” in women in their 40s, points out Rebecca. To support a healthy antioxidant defense system for women 40+, “It Starts with the Egg” recommends a few antioxidants, including 500 mg of Vitamin C and 200 IU of Vitamin E per day.
2. CoQ10 to support egg health
Beyond the prenatal vitamins, “if you are going to add just one other supplement, make it Coenzyme Q10 (CoQ10)” to support egg health, advises Rebecca. Studies have suggested that CoQ10 levels decline with age, after peaking at around age 20. For women over 40, Rebecca’s recommendation is CoQ10 in the ubiquinol form at 200 to 400 mg per day.
3. DHEA to support ovarian health
Although the science behind DHEA and ovarian health still remains controversial, based on a review of scientific literature, Rebecca concludes that DHEA is “one of the most powerful tools we have” to support reproductive health for women after 40. Since DHEA is a hormone and have a potential for side effects in some women, Rebecca’s first recommendation is to have your DHEA-S and testosterone levels tested, then discuss adding DHEA to your preconception routine with your doctor if you are below the lower half of the normal range. (Here’s our explanation on why doctors test DHEA-S, not DHEA, when women take DHEA for reproductive health.)
4. Vitamin D to support overall reproductive health
Unrecognized deficiency of Vitamin D is one of the four unexpected obstacles to pregnancy. It’s a very common condition, especially in the northern climate during winter – in the US, nearly 1 in 5 have inadequate level of Vitamin D in the blood, while about 1 in 10 are outright deficient. Ask your doctor to check your vitamin D levels, especially if you're unsure of your current status or if they may be below the recommended 40 ng/mL. Your doctor can advise whether supplementation is needed.
As always, please reach out with questions. We are with you.
