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It’s no secret that fertility is closely linked to age. But when does fertility start to change? What factors impact fertility in women? What can you do if you're struggling to get pregnant? On this page, we outline what we know about fertility in women, and the options available if you’re worried about conceiving.
You may have heard of the important role age plays in a woman’s fertility. While it’s best to question information framed around the ‘biological clock’, it’s true that a woman’s age is the biggest factor affecting fertility, both in women and straight couples. This is because of the relationship between fertility and healthy eggs, and the impact age has on egg quality.
Women are born with a finite number of eggs – around one or two million. Women ovulate around one egg a month after they begin their cycle, but the number of eggs decreases every day. As women get older, egg quality also decreases.
Men also experience infertility, but in a different way. Sperm quality is sensitive to other factors, but doesn’t change with time in the same way eggs do.
Understanding the relationship between age and female fertility can feel scary, but it’s really important if you’re planning to start a family in the future. It will empower you to have more control in each stage of life, and take the best actions for meeting your family planning goals, whether that’s in the present or the future.
If you have any questions, don’t be shy – drop us a line on our live chat or by calling us on +447897035438.
Women are considered at the peak of their fertility between their late teens and late twenties, when the ovaries contain a large number of high-quality eggs. At this time, chances of conception tend to be at their highest, although individual fertility always varies. Not every woman in her twenties will conceive naturally easily, but most do.
As a woman reaches her thirties, her fertility begins to change. The quality and quantity of eggs decrease, making it more difficult to conceive naturally, especially after 35. Still, many women in their thirties have perfectly healthy, successful pregnancies.
You may recognise the number 36 as an important age. When struggling to conceive, most health bodies advise that women that are 36 or over should get help sooner rather than later. That’s because a woman’s late thirties bring on a steep fertility decline which makes pregnancy more difficult.
Fertility used to be somewhat of a taboo subject, but this has changed over time. One positive result is that it’s helped women become more proactive about understanding their fertility earlier on. Assessments are a popular choice among women in their thirties looking to gain a better picture of their fertility, while egg freezing is a solid option for protecting egg quality until a later time.
By a woman’s mid forties, natural conception becomes unlikely, and the risk of pregnancy complications rise. Sadly, miscarriage and ectopic pregnancies become more common. One of two pregnancies in women over 45 ends in miscarriage (Tommy’s).
Many women do conceive in their forties, but it usually requires more time, and often, fertility treatment.
As women approach their fifties, periods start to become irregular. Menopause causes a woman’s menstrual cycles to stop, and her ovulation too. After this point, it’s not possible for a woman to conceive using her own eggs.
Not every woman experiences menopause in her forties or fifties. Premature menopause is estimated to affect 1% of women under 40, and .1% of women under 30 (NICE). In a few exceptional cases, women will experience early menopause before that.
Women who experience early and premature menopause can absolutely still get pregnant, but a little help is needed. In these circumstances, IVF with donor eggs has been a particularly successful avenue.
There’s no set age when a woman stops being fertile, as much as there are gradual and then steeper declines. As women, the data can feel overwhelming: the information we have shows that fertility favours younger women, but societal trends have seen mothers’ ages increasing steadily since records began in 1938, with the current mean in England and Wales around 31 (Office of National Statistics).
Try to be kind to yourself with this information. Know that if you’re hoping to get pregnant outside of a woman’s peak fertility years, you’re in the norm, not the minority. And that working with this information, while uncomfortable, puts you in the best position to make informed decisions about your future.
Age is the greatest indicator of fertility for women, but it’s by far the only one. There are several factors at play, from a healthy lifestyle to previous pregnancies and reproductive health.
When trying to conceive, general wellbeing is key, and you might be surprised by the impact lifestyle choices can have on fertility. Consuming a balanced diet rich in whole grains, healthy oils and essential vitamins is known to help. On the other hand, being either underweight or overweight can influence menstrual cycles and hormonal balance, potentially making it harder to get pregnant.
Regular physical activity helps fertility by boosting mood and regulating hormones. Although if too excessive, it can have the opposite effect.
Smoking and excessive alcohol consumption harm fertility for both men and women, which is why doctors advise quitting smoking and moderating alcohol intake to maximise chances.
The debate around the direct effect stress has on infertility is ongoing, but making efforts to manage stress is always worthwhile. Naturally, this is easier said than done, but there are good reasons to try. Prolonged levels of stress can affect hormones, while lower levels of stress are linked to better sleep and mood.
There are also certain conditions, medications and surgeries that are known to affect fertility in women.
Because of the key role ovulation plays in conception, ovulatory issues can make pregnancy more difficult. One example is polycystic ovarian syndrome (PCOS), a hormonal disorder that can alter hormones and prevent ovulation. PCOS affects around one in 10 women in the UK.
Another is premature ovarian insufficiency (POI), when a person’s ovaries begin to release eggs inconsistently and stop producing certain hormones. POI makes pregnancy more difficult, but not impossible. Thyroid disorders can also lead to irregular ovulation, alongside other hormonal fluctuations.
Other conditions that affect a woman's reproductive health include endometriosis, fibroids and blockages in the fallopian tubes, which carry the egg from the ovary to the uterus. Sexually transmitted infections (STIs) can lead to pelvic inflammatory disease (PID) if untreated, which can harm the fallopian tubes, and affect pregnancy as well. The good news is that getting tested for STIs in the UK is easy: it’s discreet, quick, and there are free options to women and men keen to get tested.
The number and outcome of previous pregnancies may also be a factor in your fertility journey, although it’s best to discuss with a doctor rather than to make assumptions. Consultants will ask about complications in previous pregnancies, such as recurrent miscarriage, preterm birth, preeclampsia or gestational diabetes – having these before may alter your care for a future pregnancy, ensuring it’s more specialised to your fertility history. Other factors such as age and other health considerations should still be taken into account.
Fertility science has come a long way. Most factors that negatively impact fertility have tried-and-tested options available to boost chances and work towards a successful pregnancy.
Infertility is unique, and there’s no one-size-fits-all solution. But help is always available, and there are a few standard port of calls if you’re unsure on your next step.
Fertility testing is the starting point for most questions around fertility. Our all-inclusive diagnostic packages are designed to help you build a picture of your fertility in a thorough and convenient way.
Our fertility testing includes an AMH test which indicates your ovarian reserve, a thyroid profile, and an ultrasound scan to assess your uterus and ovaries. We also include a consultation with a fertility specialist, who can explain your results in detail and help you explore next steps with confidence.
Check our fertility tests here.
If you are worried about the effects of age on fertility but know you’d like kids in the future, egg freezing is a great choice.
A cycle of egg freezing begins in the same way as an IVF cycle: with medication to stimulate the ovaries into producing more eggs. You’ll have ultrasound scans to check the growth of the eggs and ensure everything is progressing smoothly.
Once the eggs have reached a suitable size, they’re collected in a short procedure called egg collection, and fast-frozen using a process called virtification.
The rule of thumb is that the earlier a woman freezes her eggs, the better chances she’ll have if she chooses to use them down the line. We usually recommend freezing eggs before 35.
There are also a number of assisted reproductive technologies (ART) available if you’re ready to conceive, but are struggling naturally.
In vitro fertilisation (IVF) is the most common fertility treatment, and a strong medical choice for individuals looking to start their family.
A cycle of IVF starts with a course of fertility drugs which stimulate a woman’s ovaries to produce multiple eggs. These are then collected and fertilised in a petri dish, and monitored as they develop into embryos. A healthy embryo (or rarely, two) is then transferred back into the woman's uterus to grow in the womb, or frozen for future cycles.
IVF can be tailored to your unique situation and circumstance. For example, you can have IVF with donor eggs or sperm, or add on a step called intracytoplasmic sperm injection (ICSI) if your couple is experiencing male infertility.
Whether you’re planning to start a family now or in the future, there’s no harm in exploring your options early on so that time is on your side. If you have questions, big or small, get in touch. We’re always here to provide you the guidance and support you need to take your next steps fully informed and with confidence.
Written by our group of fertility experts and doctors consultants
Written by our group of fertility experts and doctors consultants
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