The latest photos of Kelly Preston, resplendent with her “bump,” are inspiring to older women like me who fancy the idea of “just one more” pregnancy. But is it really plausible to have a baby in your late 40s?

After surveying the spontaneous conception rates of women in their 20s versus women in their late 30s in this recent article, it seems reasonable to assume that a woman who is sustaining a pregnancy at age 47 has employed in vitro fertilization (IVF) with donor eggs.

But what if Ms. Preston did conceive this baby without the use of donor egg IVF? How could she have done it?

I connected with Dr. Rashmi Gulati, MD, medical director of Patients Medical, in New York City, who not only specializes in this area of medicine, but also gave birth to twins at age 44. She had several recommendations for women in their 40s who may be perimenopausal, but who would nevertheless like to optimize their fertility.

“Perimenopausal womens egg quantity and quality decline, which makes it more difficult to conceive and sustain pregnancy,” she explains. And even though there is not much you can do to improve the quality of your eggs, you can create the best possible conditions for your body to conceive. Here are her recommendations.

Check your hormone levels
“Miscarriage rates are 25% for women in their 40s compared to 12% to 15% for women in their 20s,” Dr. Gulati says. This may be a result of a decrease in certain hormones in a perimenopausal woman. Hormones such as estrogen and progesterone help a woman to conceive and sustain a pregnancy.

You need higher progesterone levels to sustain a pregnancy. Without enough estrogen, you may not ovulate, and you may experience vaginal dryness as well as a thinning of your uterine lining.

Pay attention to your thyroid health
“Hypothyroid is perhaps one of the most common, yet easily overlooked, causes of infertility,” according to Dr. Gulati. As thyroid disorders increase in women over the age of 35, women who want to become mothers later in life should have their thyroid tested.

Some of the symptoms of hyperthyroidism—irregular periods, moodiness, and frequent sweating—can also be confused with those of perimenopause.

Nurture yourself
Gulati recommends that women do what they can to get healthy, eliminate nutrient deficiencies with the help of a holistic physician, increase their consumption of essential fatty acids to help build up cervical mucus, and, if at all possible, to relax while trying to conceive.

Dr. Gulatis twins were conceived after she became perimenopausal. She suffered from low progesterone levels, hypothyroidism, and nutrient deficiencies, but once her system was balanced, she sustained the pregnancy with her twin girls.

It is stories like these, and Kelly Prestons, that continue to serve as a beacon of hope for potential mothers in their 40s. Although many people do conceive their late-in-life babies with donor egg IVF, it may not be impossible to create your own bump at home.