03/06/2026
🤰 Pregnancy after 40 – Possible? Absolutely.
Essential Investigations Before Pregnancy
After 40
1. Fertility Assessment
✅ AMH (Anti-Müllerian Hormone) – estimates
ovarian reserve ( EGG RESERVE )
✅ Antral Follicle Count (AFC) by transvaginal
ultrasound
✅ Day 2–3 FSH, LH, Estradiol (E2) levels, Prolactin
✅ Ovulation tracking (ultrasound follicular
monitoring if needed)
2. General Health Check-up
✅ Complete Blood Count (CBC)
✅ Blood Group & Rh Typing
✅ Blood Sugar Tests (Fasting Blood Sugar and
HbA1c)
✅ Thyroid Profile (TSH, Free T4)
✅ Liver Function Test (LFT)
✅ Kidney Function Test (KFT)
3. Nutritional Assessment
✅ Vitamin D levels
✅ Vitamin B12 levels
✅ Serum Ferritin (iron stores)
4. Infectious Disease Screening
✅ HIV I & II
✅ Hepatitis B (HBsAg)
✅ Hepatitis C (Anti-HCV)
✅ VDRL/RPR (Syphilis screening)
✅ Rubella IgG (immunity status)
5. Gynecological Evaluation
✅ Transvaginal ultrasound to assess uterus and
ovaries
✅ Pap smear (if due)
✅ Evaluation for fibroids, polyps, adenomyosis, or
ovarian cysts by ULTRASOUND
6. Tubal Assessment (if not recently done)
✅ HSG (Hysterosalpingography) or HyCoSy to
check tubal patency, especially if there is a
history of infertility.
7. Partner Evaluation
✅ Semen Analysis (even if previous reports were normal, repeat if older than 6–12 months)*
8. Genetic Counseling & Screening
Because chromosomal abnormalities increase
with maternal age:
✅ Genetic counseling
✅ Consider carrier screening based on family
history and ethnicity
💬 Are you planning pregnancy after 40 or know someone who is? Share your thoughts below!