Trying to conceive after 35: what to know

How does age affect fertility?

The American College of Obstetricians and Gynecologists describes the peak reproductive years as the late teens through the late 20s, with a decline that starts around 30 and speeds up in the mid-30s. Among healthy couples, about one in four become pregnant in a given cycle in their 20s and early 30s, and about one in ten at age 40. These are estimates for groups of people, not predictions for you.

In the PRESTO study, 79.3% of people aged 25 to 27 had become pregnant by 12 cycles, compared with 55.5% of those aged 40 to 45. That study followed couples who were planning pregnancy, relied on self-reported information and measured pregnancy, not live birth. Use the numbers for context and do not treat them as a personal forecast. The guide on how long conception takes gives the wider picture.

Biology is one part of the decision. There is no single best age that suits everyone's health, relationships, finances and support. Many people build families later, and the information here is meant to help you plan, not to set a deadline.

What else changes with age?

Age also affects pregnancy itself. Counselling usually covers miscarriage, chromosomal conditions and maternal complications such as high blood pressure and gestational diabetes. These risks do not mean a healthy pregnancy after 35 is unlikely. They are a good reason to start care early, to have a preconception visit and to keep up with prenatal appointments. Most people who conceive after 35 have healthy pregnancies and babies.

The age that counts for egg-related fertility is the age of the person who provides the eggs. If you use donor eggs, the donor's age matters for the egg, and the age of the person carrying the pregnancy still matters for pregnancy health.

When should you ask for help?

If you have irregular periods, suspected endometriosis, a known sperm problem or other concern, seek advice earlier at any age. Both partners are assessed together, because ovulation, anatomy and sperm all matter. The male fertility guide explains what a semen analysis involves.

How do you find fertility care where you live?

The clinical reasons to seek help are similar everywhere, and access is not. Funding and referral depend on the country, and often on the region.

• United Kingdom. NHS fertility funding depends on where you live. In England, local integrated care boards decide, and the other UK nations have their own criteria.
• United States. Insurance rules vary by state and plan, and some employer plans are exempt from state mandates.
• Australia. Medicare gives some assistance for fertility and IVF services, and provider charges still apply.
• Canada. Provinces run different programmes, from funded IVF cycles to tax credits.

Elsewhere, start with your health ministry or public insurer, and ask what is covered, what extras cost and how long the wait is.

What can an AMH test tell you?

Anti-Müllerian hormone (AMH) and antral follicle count help doctors predict how your ovaries may respond to stimulation during fertility treatment. They do not measure egg quality, and they do not reliably show your chance of conceiving naturally. A low result does not mean pregnancy is impossible, and a normal result does not guarantee future fertility.

A 2024 study of 3,150 women who bought a commercial hormone test found that low AMH, below 1 ng/mL, was linked with a lower conception rate in the first months of trying. The study group was a self-selected one, pregnancy was self-reported and some authors had company ties. The finding does not give an accurate forecast for any individual, and it does not show that screening improves results.

Read an AMH number as one piece of information. If you are thinking about an AMH test, ask what question it would answer and whether the result would change your plan. For example, it can help someone deciding about egg freezing or IVF, and it is less helpful for a person who is still deciding when to start trying.

Is egg freezing worth considering?

Egg freezing, also called planned oocyte cryopreservation, is an option for people who want to try later. The American Society for Reproductive Medicine finds better outcomes when eggs are frozen at younger ages. The evidence is not enough to give a universal number of eggs that guarantees a live birth. Not everyone who freezes eggs comes back to use them, which affects how programme statistics read.

If you are thinking about it, ask a clinic for estimates that match your age group, and check what the figures count: eggs, thaw cycles, transfers or people. Ask about the costs of the retrieval cycle, storage each year and the treatment needed later. Egg freezing is not an insurance policy. It can widen your options, and it comes with costs and no guarantee.

What is carrier screening?

Carrier screening checks for changes in genes that can lead to inherited conditions in a baby, even when neither parent has symptoms. Testing before pregnancy gives you more time to understand results and consider options. It is voluntary, and a negative result does not remove every genetic risk. Offers and insurance coverage differ by country, so ask your provider what applies where you live.

What steps can you take now?

• Book a preconception visit. Review medicines, long-term conditions, vaccines and family history.
• Start folic acid. See folic acid before pregnancy.
• Time sex to the fertile window. The ovulation day guide shows how, and the best time to get pregnant calculator finds your dates.
• Include your partner. A semen analysis is a standard part of the assessment.
• Stop smoking and limit alcohol. Both affect fertility and pregnancy.
• Look after your wellbeing. Waiting is stressful. Support is available, and asking for it is sensible.

What should you ask your provider?

Bring a short list to your visit:

• Given my age and history, when should we consider tests?
• Which tests would change the plan, and which would only add worry?
• Is my cycle pattern a reason to look sooner?
• Do you recommend a semen analysis for my partner now?
• What are the options if conception takes longer, and what do they cost?
• Is any add-on treatment you offer backed by evidence of more live births?
• Would an AMH test or egg freezing make sense for me?