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Trying after 35

A woman's fertility falls gradually through her thirties and faster after about 37. That does not mean it is too late, but time matters more, so it is worth getting checked sooner and having a clear plan.

With Datuk Dr. Navdeep Singh Pannu, FRCOG, at Alpha IVF & Women's Specialists, Kota Damansara

Book a consultation Your first visit
See a specialist
After 6 months of trying from 35; sooner from 40
First tests
AMH, a pelvic scan and a semen analysis
Main change
Fewer eggs, and more with chromosome problems
Both partners
Men's age matters too, though less

What it is

Women are born with all their eggs. With age there are fewer of them, and a larger share carry the wrong number of chromosomes. This makes it slower to conceive and raises the chance of miscarriage.

Age is not the only thing that counts. Your egg reserve, your partner's sperm, your tubes and your general health all shape the plan, so the first step is to test both of you.

The aim is to use your time well: not waiting longer than needed, but not jumping to treatment that will not help either. For some couples that means a short trial of simpler treatment; for others, going straight to IVF.

Who it can help

  • Women aged 35 or over who have been trying for six months
  • Women over 40 who want advice before they start trying
  • Planning a second child later in life
  • Irregular periods or a known low egg reserve
  • Thinking about freezing eggs or embryos while there is still time

How it works

  1. Tests for both of you

    An AMH blood test and a scan to count the follicles, other hormone tests, a check of the tubes, and a semen analysis.

  2. An honest talk

    What your results mean at your age, how much time is reasonable to try each option, and what is realistic.

  3. A plan

    This may be a few cycles of ovulation tracking or IUI, or moving to IVF sooner. Embryo testing (PGT-A) may be discussed.

  4. Health before pregnancy

    Folic acid, and checks of blood pressure, blood sugar and weight, since these matter more for pregnancy later in life.

  5. Review

    Results are looked at after each step, and the plan is changed if something is not working.

Good to know

Side effects and risks

  • A higher chance of miscarriage and of chromosome conditions such as Down syndrome
  • More chance of high blood pressure, diabetes in pregnancy and caesarean birth
  • IVF may need more than one cycle to give a suitable embryo

Do not wait too long

If you are 35 or over and have been trying for six months, book an assessment. From 40, there is no need to wait at all.

Eggs or embryos for later

If you are not ready yet, freezing eggs or embryos now keeps them at today's age. See egg freezing.

Pregnancy care

Once you are pregnant, routine screening and antenatal care help pick up problems early.

Questions people ask

Is it too late to have a baby after 40?

Many women do, naturally or with treatment. The chances are lower than in your thirties, so Dr. Navdeep will tell you honestly what to expect from your own results.

Should we go straight to IVF?

Not always. It depends on your egg reserve, your tubes and the sperm. Sometimes simpler treatment is worth a short try; sometimes IVF saves time.

Does a normal AMH mean my eggs are fine?

AMH shows roughly how many eggs are left, not their quality. Quality depends mostly on age.

Does PGT-A help older women?

It can help choose an embryo with the right number of chromosomes and avoid a transfer likely to miscarry. It does not make more embryos or raise the overall chance of a baby from a cycle. See PGT embryo testing.

Further reading

This page is general information and does not take your personal circumstances into account. Please speak to your doctor for advice that is right for you. Disclaimers