Deepika Padukone embraces motherhood in her 40s: What top gynaec says about fertility, safety and IVF

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That reality is also getting reflected in popular culture with women actors like Katrina Kaif, Sonam Kapoor and now Deepika Padukone embracing motherhood in their 40s. Most pregnant women in this age group feel comfortable about motherhood after prioritising their personal milestones, emotional maturity and financial security. “With the right guidance and discipline, such pregnancies can have positive outcomes,” says Dr Suri, while talking about some need-to-knows with The Indian Express. What are the natural chances of conception after 40, and when does IVF become the preferred option? Natural conception after 40 is still possible, but the chances are lower, around 20–30%, provided ovarian function is still reasonably normal. It is usually advised to try naturally for up to one year (with proper medical evaluation). If conception does not happen and fertility indicators are declining, IVF (in-vitro fertilisation where retrieved eggs and sperm are fertilised in a laboratory setting and the resultant embryo is either frozen for future use or implanted in the woman’s uterus) is recommended. What role do egg freezing and fertility preservation play in enabling late pregnancies? Egg freezing plays a crucial role today, especially as women are marrying later or deciding to have a baby in the later stage. Eggs preserved at a younger age (around 30–35) are of better quality than those at 36–37 or beyond. It allows women to “store” healthier eggs and use them later when they are ready to conceive. This is particularly helpful for women who may not yet have a partner or are delaying pregnancy for personal or professional reasons. The biggest challenge is the ovarian reserve or the number of healthy eggs remaining in a woman’s ovaries that have the potential to be released for fertilisation and pregnancy. A woman is born with a finite number of eggs and both their quantity and quality decline over time. That’s why there’s a much-reduced chance of natural conception. What are the major health risks and precautions for women conceiving in their 40s? Pregnancy after 40 carries higher risks, including increased chances of genetic abnormalities in the baby, higher risk of pre-term labour and pregnancy complications, increased likelihood of gestational diabetes and metabolic disorders, structural changes in the uterus that can affect pregnancy. Since women over 40 usually enter the peri-menopausal stage when they undergo hormonal imbalances and disruptions, their bodies go through a change and may be more prone to developing hypertension, diabetes – particularly pregnancy-induced or gestational diabetes – IUGR (intrauterine growth retardation, babies are weaker and frail), and preeclampsia (high blood pressure that damages other organs like the kidneys). That’s why women must have regular and close antenatal check-ups, timely genetic testing during pregnancy, careful monitoring to prevent miscarriage and preterm birth and continuous medical supervision due to age-related metabolic changes How do IVF success rates differ for women above 40 compared to younger age groups? IVF success rates are lower in women above 40. Younger women tend to have better outcomes because the egg quality is higher and their uterus is more receptive and elastic. As age increases, both egg quality and uterine conditions decline, reducing success rates. What lifestyle or medical factors can improve fertility outcomes in late motherhood? Early and regular gynaecological check-ups are important, even from adolescence. Conditions like endometriosis can start early and impact future fertility. Timely fertility assessment helps in better planning of pregnancy. Taking action at the right time, instead of delaying evaluation, leads to better outcomes. Is birth easier for those who are attempting a second baby in their 40s? The physical process of labour is often faster and easier than the first, but the pregnancy itself carries a higher risk of similar complications and requires closer medical monitoring. While age-related challenges are present, prior experience with childbirth generally makes the second delivery easier. What myths around pregnancy after 40 need to be addressed? A common misconception is that assisted reproductive techniques like IVF make it easy to conceive at any age. However, that is not the case. Even with these technologies, conception becomes more challenging after 40. The risks of miscarriage and other complications remain higher, and overall fertility outcomes are still strongly dependent on age, with better results seen in younger women. Those intending to be mothers should amp up their physical activity gradually, beginning with yoga and regular walks. Those who are fitter and already used to more intense routines like running and swimming can do so till the first trimester but slow down in the later trimesters. Diet should be low-carb, low fat, high-protein with a lot of fruit and vegetables and up to three litres of fluids.