How age affects fertility

As you get older, it may take longer to get pregnant. Some people may need medical help to conceive. This is called assisted conception.

Age and fertility

Many people are having babies later in life for lots of reasons, such as not feeling ready to support a child (for example, with money or housing), or not having met a partner they want to have a child with. 

As you get older, getting pregnant can be more of a challenge, and the risk of miscarriage does increase. Although men and people assigned male at birth are fertile for longer than women and birthing people , their fertility also decreases with age, just not as much. This is because sperm quality lowers with age.

Why does ageing affect my fertility?

Fertility decreases with age for women and birthing people, particularly after the age of 35, because the number and quality of eggs gets lower.

Generally, an egg is sent from your ovaries to your womb every month, from when you hit puberty to the menopause. When the egg and sperm join in the womb you get pregnant. 

Your body doesn’t make a new egg every month. Women and birthing people are born with all the eggs they will ever have, stored in the ovaries. As you get older your eggs get older too.

How long it takes to get pregnant depending on age

The following is a breakdown of conception by age. It shows how many women and birthing people will get pregnant within 1 year of having regular, unprotected sex.

• aged under 30: 85 out of 100 will conceive within a year
• at age 30: 75 out of 100 will conceive within a year
• at age 35: 66 out of 100 will conceive within a year
• at age 40: 44 out of 100 will conceive within a year.

However, official statistics for England and Wales also show rising numbers of women and birthing people aged 35 and over having babies. The number of babies born to those aged 40 and over increased by a fifth between 2011 and 2021.

There are several causes of fertility problems, but sometimes an exact cause can’t be found. This is called ‘unexplained infertility’. Unexplained infertility is rare for people in their 20s, but becomes the most common diagnosis of infertility in people over 35 years of age. 

There are treatments such as in vitro fertilisation (IVF) that may help you conceive if you have fertility problems.

When to start seeking advice and help for fertility problems

See your GP if you’ve been trying for a year or more to conceive. Book in with them sooner If you are 36 or over.

If you know you have any other health concerns related to fertility, such as endometriosis, polycystic ovary syndrome (PCOS) or thyroid problems, you should also make an earlier appointment with your doctor.

Age is not the only thing that can affect your fertility. Other lifestyle factors that may make it more difficult to get pregnant include:

• smoking
• drinking alcohol
• using drugs
• having a high BMI
• having a sexually transmitted infection.

Your GP can check what might be the cause of your fertility problems and suggest treatments that may help.

Your age and free IVF on the NHS

Fertility treatments, such as IVF, can help you conceive. 

If tests show you have a fertility problem which means IVF is the only treatment likely to help you get pregnant, you should be referred for IVF on the NHS.

The National Institute for Health and Care Excellence (NICE) is the body that makes recommendations to NHS trusts (the organisations that run local health services) about what treatment to offer. 

If you have unexplained fertility you'll need to meet NICE's criteria for free IVF on the NHS.

That means if you're under 40 and living in England, Wales or Scotland you may have 3 full cycles of IVF if:

• you have been trying to get pregnant through regular unprotected sex for 2 years, OR
• you have had 8 cycles of artificial insemination, including at least 4 cycles of intrauterine insemination (IUI). Artificial insemination is a fertility treatment that involves inserting sperm into the womb.

If you live in Northern Ireland you may be offered 1 cycle of IVF and 1 frozen embryo transfer if:

• you have been trying to get pregnant through regular unprotected sex for 2 years, OR
• you have had 8 cycles of artificial insemination with at least 4 of the cycles using IUI.

If you turn 40 during treatment your current cycle will be completed, but further cycles shouldn't be offered.

If you are aged 40 to 42 anywhere in the UK you may be offered 1 full cycle of IVF if all of the following apply:

• you have been trying to get pregnant through regular unprotected sex for 2 years, or you have had 12 cycles of artificial insemination including at least 6 cycles of IUI
• you have never had IVF treatment before
• your fertility tests show that your ovaries would respond normally to fertility drugs
• you and your doctor have discussed the risks of fertility treatment and pregnancy.

IVF isn't usually recommended for women and birthing people over the age of 42 because the chances of a successful pregnancy are thought to be too low.

In reality, local trusts may also ask for other criteria. These might include:

• not having any children yet
• being a healthy weight
• not smoking
• being under a certain age.

Ask your GP what the criteria for NHS-funded IVF treatment are in your area.

What happens if my partner is older?

The ability to have a baby also declines for men with age, because sperm quality drops with age. However it seems to have less of an impact on fertility than the age women and birthing people.

Other reasons why older men may have less chance of pregnancy:

• less interest in sex
• erectile dysfunction
• lower levels of male sex hormones.

How can my age affect my pregnancy?

Many people over the ‘ideal’ childbearing age have healthy pregnancies and babies, but complications in pregnancy such as miscarriage also increase with age.

Miscarriage happens in around:

• 1 in 10 pregnancies in those younger than 30
• 2 in 10 pregnancies in those aged 35 to 39
• More than half of pregnancies in those older than 45.

If you’re over 35, you also have a higher chance of having an ectopic pregnancy. 

If you're over 40 and pregnant you are more like to have:

• high blood pressure
• gestational diabetes
• twins or triplets, which may cause complications
• a baby with Down’s syndrome
• pre-eclampsia (a pregnancy condition that can be dangerous for mother and baby)
• a longer labour
• a caesarean section
• a stillbirth.

Will I get any extra care if I am pregnant and over 40?

Perhaps. It depends on other factors that may affect your pregnancy. If you are over 40 and there are other health concerns, then your midwife, GP, obstetrician or specialist teams may all be involved in your care during pregnancy. 

You may also be offered more tests to check that you and your baby are healthy as part of your antenatal care.

Your midwife will explain more about what your care plan will look like at your booking appointment. You’ll also have the chance to ask questions and talk about any concerns you have. 

Make sure you attend all your antenatal care appointments, so that the midwives can monitor your pregnancy and offer you further check-ups if they have any concerns.

What can I do to have a healthy pregnancy?

The best thing you can do if you are planning to have a baby at any age is to make sure you are healthy before you get pregnant. You can do this by:

• being as close as you can to a healthy BMI
• taking folic acid for at least 2 months before conception
• doing regular exercise
• eating a healthy, balanced diet
• stopping smoking
• cutting your caffeine intake down to under 200mg a day
• quitting alcohol and illegal drugs
• talking to your doctor or healthcare professional about any existing medical conditions
• being tested for sexually transmitted diseases (STIs) if there's any reason to think you may have caught one
• having a cervical screening test if you haven’t had one in the past three years
• making sure you have had the MMR vaccine.