Mumbai: Hollywood actor Hilary Swank’s reported pregnancy at 52 has renewed discussion about fertility, assisted reproductive technology and the medical considerations involved in having a baby later in life.
The two-time Oscar winner, who welcomed twins with her husband, Philip Schneider, in April 2023 at the age of 48, announced that she was expecting another child in an Instagram post on October 15, according to the supplied report. The baby is reportedly due in December.
Swank has previously spoken about freezing her eggs at 37, a decision that may have preserved reproductive options for the future. However, she has not publicly disclosed how she conceived her reported third pregnancy, and it would be speculative to assume that she used in vitro fertilisation (IVF), frozen eggs or donor eggs.
Her reported pregnancy has raised a broader medical question: how can women conceive in their 50s, and what are the risks of carrying a pregnancy at that age?
Doctors explain that assisted reproductive technology can make pregnancy possible for some women after natural fertility has declined or menopause has occurred. However, conception and the ability to carry a pregnancy safely are separate considerations, particularly when age-related health risks are involved.
How is pregnancy at 52 possible?
A woman’s fertility generally declines with age because both the number and quality of her eggs decrease. The decline becomes more pronounced as she approaches menopause, when menstrual periods and natural ovulation eventually stop.
After menopause, natural conception is generally no longer possible because the ovaries no longer release eggs regularly. However, the uterus may still be capable of carrying a pregnancy with appropriate medical treatment in selected circumstances.
“More often than not, a pregnancy at 52 is iatrogenic,” said Dr Anita Soni, director of obstetrics and gynaecology at Dr L H Hiranandani Hospital, Mumbai, referring to pregnancy achieved with medical intervention. She explained that IVF using donor eggs is one route through which women may conceive at this age.
Dr Sunita Tandulwadkar, president of the Indian Society for Assisted Reproduction and head of IVF and endoscopy at Ruby Hall Clinic, Pune, said assisted reproductive technology can help women conceive using previously frozen eggs, embryos or donor eggs.
The suitability of each option depends on an individual’s reproductive history, medical condition and clinical assessment. Fertility treatment also does not guarantee a successful pregnancy or birth.
What role do frozen eggs and donor eggs play?
Egg freezing allows a woman to preserve eggs collected at an earlier age for possible use in the future. Because egg quality is closely linked to the age at which the eggs were collected, eggs frozen when a woman is younger may offer reproductive advantages over eggs retrieved later in life.
Frozen embryos are another possible option for women who have undergone fertility treatment previously.
Donor eggs can provide an alternative when a woman’s own eggs are no longer suitable for conception. In an IVF cycle, an egg is fertilised in a laboratory and the resulting embryo is transferred into the uterus after appropriate preparation.
Using younger donor eggs can reduce some risks associated with age-related egg quality, including the increased likelihood of chromosomal abnormalities in eggs from older women. It does not, however, remove the health risks associated with pregnancy at an advanced maternal age.
In Swank’s case, her earlier comments about egg freezing do not establish whether frozen eggs, embryos or any other fertility treatment were involved in her current pregnancy.
What are the risks of pregnancy after 50?
Pregnancy at an older age requires careful medical assessment because the likelihood of certain complications increases with age.
These complications can include:
- High blood pressure and pre-eclampsia: Pregnancy-related hypertension can pose serious risks to both the mother and baby.
- Gestational diabetes: Changes in the body’s ability to regulate blood sugar during pregnancy can create additional medical challenges.
- Premature birth: A higher-risk pregnancy may be associated with an increased chance of delivery before the baby reaches full term.
- Restricted foetal growth: Some pregnancies are affected by problems with the placenta or the supply of nutrients and oxygen to the developing baby.
- Caesarean delivery: Older mothers may have a greater likelihood of requiring a caesarean section, depending on their health and the circumstances of the pregnancy.
- Newborn complications: Premature birth and other pregnancy complications can increase the possibility that a baby will require specialised neonatal care.
Dr Soni stressed that pregnancy at this age carries significant risks and requires monitoring in a tertiary-care hospital with access to a multidisciplinary medical team.
The level of risk varies between individuals. A woman’s overall health, medical history, blood pressure, blood sugar levels and other clinical factors all influence the management of pregnancy.
Is pregnancy in your 50s harder on the body?
Pregnancy places additional demands on the heart, blood vessels, kidneys and other organs. These demands may be more difficult to manage for women who already have conditions such as hypertension, diabetes or cardiovascular disease.
“Different mothers often experience different experiences, but relatively it can be harder on the mother at that age,” Dr Tandulwadkar said.
Some women may experience greater physical discomfort during pregnancy or face additional challenges during recovery after childbirth. However, age alone cannot determine an individual woman’s outcome.
Doctors therefore recommend a comprehensive medical assessment before fertility treatment or pregnancy at an advanced maternal age. Depending on the circumstances, care may involve obstetricians, fertility specialists, physicians and other specialists who can monitor potential complications.
Close supervision can help identify problems and guide treatment, but it cannot eliminate every risk.
Can women over 50 access IVF in India?
Women seeking fertility treatment in India must also consider the legal framework governing assisted reproductive technology.
Section 21(g) of the Assisted Reproductive Technology (Regulation) Act, 2021, specifies eligibility conditions for women receiving ART services, including an age requirement of above 21 and below 50 years.
This creates a significant legal barrier for women seeking such treatment at 50 or older. The applicable rules and any relevant legal developments must be considered alongside clinical suitability.
Fertility treatment can also involve substantial financial costs, medical investigations and repeated consultations. Even when treatment is legally available, the decision requires careful consideration of the potential benefits, medical risks and likelihood of success.
A specialist can explain the options available in an individual case and assess whether treatment is appropriate.
Do celebrity pregnancies create unrealistic expectations?
Celebrity pregnancy announcements can be inspiring for women who wish to become mothers later in life. However, they may also create unrealistic expectations when the medical assistance, costs and uncertainties involved are not discussed.
Dr Tandulwadkar cautioned that celebrity experiences should not be treated as representative of every woman’s reproductive journey. She emphasised the importance of realistic expectations, counselling and individualised medical advice.
A successful pregnancy in the 50s does not mean that the same outcome will be possible for everyone. Fertility treatment outcomes vary, and pregnancy risks depend on several factors beyond age alone.
It is also important to distinguish the possibility of achieving pregnancy from the likelihood of carrying it safely to term. Both require separate medical considerations.
What Swank’s reported pregnancy highlights
Swank’s reported pregnancy has brought renewed attention to the possibilities created by advances in reproductive medicine. Egg freezing, embryo preservation and donor-egg IVF have expanded the options available to some women who want to become mothers later in life.
At the same time, pregnancy after 50 remains a medically complex undertaking. Age-related changes in reproductive health and the increased likelihood of certain pregnancy complications make specialist assessment essential.
Swank has not disclosed the method of conception involved in her reported pregnancy, so her personal experience cannot establish which fertility options were used or what medical risks she may face.
The broader lesson is that reproductive choices should be informed by accurate medical advice rather than celebrity comparisons. Pregnancy in the 50s may be possible in selected circumstances, but it is neither guaranteed nor risk-free.