If you have waited or are waiting to start a family, you’re not alone. In fact, it’s increasingly popular to wait until later in life to have children. In 2019, the median age at which people with ovaries gave birth was 30 years old. Many factors may contribute to this decision for each person, including financial security, career goals, caretaking responsibilities, housing, finding a partner, or life goals outside of having children. As you may know, maternal age affects fertility, especially as you near or pass your fortieth birthday. However, artificial reproductive technologies (ART) can help you become a parent if age is a factor in your efforts to get pregnant.

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• Your reproductive potential will begin to decline in your thirties, especially after age 35, as the quality and quantity of your eggs decline.
• If you know that you want to get pregnant later and are concerned about the age of your eggs, egg and embryo freezing may help preserve your fertility.
• Artificial reproductive technologies like in vitro fertilization (IVF) can help people get pregnant, but success rates for these also decrease with age.

How Does Maternal Age Affect Fertility?

To start, did you know that as babies, we are born with all the eggs – about one to two million – that we will ever have? Though only a small fraction of these eggs are ovulated, the eggs age along with you. This means that your greatest reproductive potential is in your twenties. Your reproductive potential will begin to decline in your thirties, especially after age 35, such that a person trying to conceive at age 30 has a 20% chance of getting pregnant each month, but a person trying to conceive at age 40 has less than a 5% chance of getting pregnant each month.

There are several reasons why this decline occurs. The quality of your eggs will decline with time, and thus a greater percentage of eggs in later life may have chromosomal abnormalities (such as Down syndrome or Edwards syndrome) that may cause miscarriage or affect the health of the baby. Additionally, as you age, you are more likely to develop conditions that may affect your fertility, such as endometriosis, pelvic inflammatory disease, and uterine fibroids.

The quantity of eggs in the ovaries (also known as a person’s ovarian reserve) will also decrease over time and become less sensitive to stimulation by follicle stimulating hormone (FSH). FSH is a hormone secreted by the anterior pituitary gland which helps control the menstrual cycle and stimulates the growth of eggs in the ovaries.

This information can feel discouraging, but it is always helpful to understand how our bodies, and ovaries, will evolve over time. People have certainly conceived healthy babies in their early forties! Artificial reproductive technologies can help, as well.

What Are My Options If I’m Over 35 and Want To Get Pregnant?

If you are over 35 years old, in a heterosexual relationship, and have been trying to conceive for six months, it may be time to see a fertility specialist. If you are over 40 years old, in a heterosexual relationship, and would like to conceive, you may choose to see a fertility specialist right away. (For most single parents by choice or people in non-heterosexual relationships, seeing a fertility specialist will be part of your journey to parenthood regardless of your age.) Your fertility specialist can help identify any issues you may face when trying to conceive.

If you know that you want to get pregnant later and are concerned about the age of your eggs, starting ART through egg freezing and embryo freezing may help preserve your fertility. Your IVF cycle begins when you complete the ovarian stimulation and egg retrieval process, and the age of your eggs at the time of retrieval is a big factor in the success of your complete IVF cycle. During IVF, you may consider doing pre-implantation genetic testing (PGT) on your embryos to ensure that they don’t have any chromosomal or genetic abnormalities. You can also consider using donor eggs, sperm, or embryos to help you conceive through IVF.

How Does Age Impact IVF Success?

While ART has offered many people the chance to become parents, it is important to understand what ART can do. As you age, the decline in the quality and quantity of your eggs also affects your potential for success with IVF. Success rates as defined by live births per IVF cycle decrease as a patient nears their forties. Here are the IVF success rates by age for patients with ovaries using their own eggs.

It’s important to note that these success rates for IVF outcomes are defined by the age of the patient at the time of egg retrieval, not when the embryo transfer to the uterus occurs. If you are using eggs or embryos frozen when you were younger, your success rates are measured by your age when the eggs were retrieved.

For patients who are struggling to get pregnant with their own eggs, it may be helpful to know that success rates for patients using donor eggs are much better. Donor eggs usually come from patients who are younger and in good health, which affects the quality of the eggs. Since IVF success rates are highly dependent on the age of the person undergoing ovarian stimulation, this can greatly increase success rates. In fact, according to the 2019 SART National Summary Report, the live birth rate using fresh donor eggs was 44.7%, and with frozen donor eggs it was 40.5%. For patients looking at low success rates with their own eggs, this is a huge difference, especially considering the effort and expense required to complete IVF.

How Can I Maximize My Chance of Success?

While you may not be able to control your age, maintaining a healthy diet and healthy weight will help your fertility. You can also take CoQ10 supplements, which have been shown in some small studies to improve egg maturation rates and reduce chromosomal abnormalities (1). It is also better to see a fertility doctor sooner rather than later to understand your particular fertility characteristics, review your options for preserving your fertility, and/or begin fertility treatment for age-related infertility.