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, including financial security, career goals, caretaking responsibilities, housing, finding a partner, or life goals outside of having children. As you may know, maternal age does affect your fertility, especially as you near or pass your fortieth birthday. However, artificial reproductive technologies (ART) such as in vitro fertilization (IVF) can help you become a parent if age is a factor in your efforts to get pregnant.

How does maternal age impact IVF success rates?

At birth, your ovaries contain about 1-2 million immature, egg-containing follicles. Though only a small fraction of these eggs develop to maturity and are ovulated, all your 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.

Reduced Egg Quality

The quality of your eggs will decline with time, and thus a greater percentage of eggs later in 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.

Reduced Egg Quantity

The quantity of eggs in your ovaries (also known as your 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.

Poor Embryo Quality

The percentage of chromosomally normal (euploid) embryos formed during IVF decreases with maternal age at the time of egg retrieval. This may be because egg quality is lower, resulting in lower quality embryos.

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 think that you may want to get pregnant at some point in the future and are concerned about the age of your eggs, starting ART through egg freezing and embryo freezing may help preserve your fertility. Because egg quality declines with age, egg/embryo freezing is a way to preserve higher quality eggs for a pregnancy attempt at a later time. Not everyone knows that the age of your eggs at the time of retrieval is a big factor in the success of your complete IVF cycle. This is so much the case that your chance of success with IVF (the likelihood that you will have a live birth) is measured by your age when your eggs were retrieved, not your age when they are transferred!

During egg/embryo freezing or 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.

IVF Success Rates by Age

While IVF has offered many people the chance to become parents, it is important to understand what IVF 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 using their own eggs.

The live birth rate per IVF cycle decreases by age. The live birth rate for people under 35 is 55%, for people 35-37 is 41%, for people 38-40 is 26.8%, for people 41-42 is 13.4%, and for people over 42 is 4.3%.

Remember, it’s important to note that these success rates for IVF outcomes are defined by the age of the egg provider at the time of egg retrieval, not when the embryo is transferred to the uterus. 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.

IVF Success Rates for the First IVF Cycle by Age

While the chart above showed the average success rate by cycle, the graph below shows the success rates for the first IVF cycle, by age. This helps you understand how successful patients are when they are just starting out with IVF.

Patients who begin IVF when they are under 30 have a 63% average success rate. However, this success rate decreases with age, so that patients over 42 have a 5% average success rate on their first IVF cycle.

IVF Success Rates Using Donor Eggs

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 egg retrieval, 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%, regardless of the age of the patient. For patients looking at low success rates with their own eggs, this can be a huge difference, especially considering the effort and expense required to complete IVF.

How can I maximize my chance of success with IVF?

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.