Women’s fertility and age: knowing what to expect

Medically reviewed by Rosanna Sutherby, PharmD on April 13, 2020. Written by Libby Pellegrini. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


There are significant differences between a woman’s fertility during her 20s, compared to her 30s, 40s, or even 50s. Read on to learn more about female fertility, fertility statistics by age, the likelihood of pregnancy at different ages, and more.


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Fertility and the reproductive cycle

Conception, or the beginning of pregnancy, occurs when a woman’s egg cell is fertilized by a male’s sperm cell. Women are born with a specific egg count that decreases over time. In general, at birth a female will have up to 1-2 million oocytes (immature eggs), according to researchers—and by the time a woman has her first menstrual cycle, she’ll have about 300,000 to 500,000 oocytes remaining.

During the menstrual cycle each month, a woman’s ovary releases an oocyte, which travels down the fallopian tube and arrives at the uterus. Menstrual hormones, including estrogen, help the egg cell prepare for fertilization by a sperm cell. They also help the uterus prepare for implantation of the fertilized egg. (Related: What are normal estradiol levels in women?)

If conception does not occur, the unfertilized egg cell dies, and the uterine lining is shed in the form of a menstrual period. This cycle continues as a woman ages, so the number of oocytes that are available for fertilization, also known as “ovarian reserve,” decreases with advancing age.

Fertility and age: what to expect in your 20s, 30s, and 40s

Fertility in your 20s

When it comes to age and fertility, the 20s are a woman’s most fertile period. During your 20s, you tend to have the highest chance of conceiving. Research indicates that among women who are age 25, there’s an 87% chance of conceiving after 12 months of trying through sexual intercourse.

What is the peak fertility age for a woman?

A woman’s peak fertility age is typically seen in her early- to mid-20s. During this decade, the ovaries have a relatively large number of healthy eggs, and the likelihood of fertilization each month is at its highest.


Fertility in your 30s

Fertility gradually declines over time: studies show that a steep decline tends to occur after age 32, and it becomes even more rapid after age 37. However, during her 30s, a woman’s chance of getting pregnant is still 20% each month, on average.

After age 35, a woman is considered to be of “advanced maternal age” (AMA), which means that an OBGYN or reproductive specialist may consider her pregnancy to be at a higher risk.

Advanced maternal age has implications for a pregnancy because it is associated with a higher risk of miscarriage, as well as chromosomal abnormalities in the child. This may be due to a decrease in egg quality that can result when higher levels of certain hormones circulate in the blood (such as follicle-stimulating hormone, or FSH).

A pregnancy after age 35 is also considered higher risk because it has health implications for the mother, who faces a higher likelihood of pregnancy-related complications such as gestational diabetes.

If you’re interested in knowing more about your own fertility and reproductive hormones, you can use the Everlywell at-home Women’s Fertility Test to check your hormone levels from the comfort of home.

Boosting fertility in your 30s

Wondering how to boost fertility in your 30s? The general principles of women’s health are very important when it comes to having a successful pregnancy. Effective stress management and avoiding cigarette smoking, excessive alcohol intake, and excessive exercise can help increase your chances of getting pregnant in your 30s.

Visiting a fertility specialist, and discussing treatment methods such as in vitro fertilization (IVF), can also help increase your chances of a successful pregnancy as you approach your late 30s.


Fertility in your 40s

Though there’s a decline in female fertility with age, it’s still possible for a woman to get pregnant during her 40s.

According to the American Society for Reproductive Medicine, a woman’s chance of getting pregnant is 20 percent each month in her 30s, and this drops to 5 percent each month in her 40s.

Fortunately, assisted fertility treatments are available to women who are in their 40s—and many women in their 40s give birth to healthy babies. In fact, the fastest-growing category of pregnant women is women who are age 40 to 44, according to fertility rate data collected by the U.S. Centers for Disease Control and Prevention (CDC).


Can a 50-year-old woman get pregnant?

For most women, the 50s represent the onset of menopause (on average, women enter menopause at age 51), which is the time when changes in a woman’s body cause ovulation and the menstrual cycle to cease completely. Once this has happened, it’s practically impossible to become pregnant naturally.

But for some women in their 50s, it’s still possible to get pregnant—especially if assisted reproductive technologies like in vitro fertilization (IVF) are used. In fact, there’s been an increase in births among mothers over age 50 in the United States. In the year 2018, 959 mothers over age 50 gave birth.

Causes of fertility problems

Age is not the only factor when it comes to fertility. The definition of infertility is the lack of an achieved pregnancy after 12 months of routine sexual intercourse if you are younger than age 35, or the lack of an achieved pregnancy after 6 months of routine sexual intercourse if you are older than age 35.

If you have ever struggled with infertility, you aren’t alone. In fact, 13% of women age 15 to 44 have been diagnosed with impaired fecundity, which is the medical term that means a decreased ability to conceive or carry a pregnancy to full term.

Some medical conditions, such as previous pelvic inflammatory disorder (PID), endometriosis, uterine fibroids, thyroid dysfunction, or polycystic ovarian syndrome (PCOS), can be related to impaired fertility. If you have one of these conditions and may be experiencing female infertility, make sure to follow up with your healthcare provider.

What about male fertility?

For a man’s fertility, age is a consideration—but much less so than for a woman. Both sperm count and sperm quality do tend to decrease over time in men, but this doesn’t seem to affect male fertility until a man reaches his 60s.

When it comes to male fertility, certain factors can increase the quality of a man’s sperm and the likelihood of a successful pregnancy.

These male fertility factors include:

  • Lifestyle choices, like maintaining the recommended body mass index (BMI) and avoiding cigarette smoking and excessive alcohol consumption
  • Trauma to the testes or previous testicular surgery

Certain kinds of environmental exposures—like radiation, pesticides, lead, cadmium, or mercury—can affect male fertility. Frequent exposure of the testes to high temperatures (such as those in a sauna or hot tub) and certain medical conditions—like diabetes, autoimmune disorders, certain hormonal disorders, or previous cancer with chemotherapy—can also affect male fertility.

What can I do about my own fertility?

Women’s fertility can be assisted with reproductive medicine techniques. Reproductive medicine uses assisted reproductive methods to support fertility in women who have had difficulties conceiving a pregnancy naturally.

The most common form of assisted reproductive technology (ART) is known as in vitro fertilization (IVF). During an IVF treatment, medications are used to stimulate the egg cells in a woman’s ovaries. These egg cells are then harvested using a needle. They are fertilized (using sperm) in a laboratory setting. Then, one or more of these fertilized egg cells are re-inserted into a woman’s uterus for implantation and, hopefully, the development of a successful pregnancy. If more than one fertilized egg cell is implanted in the uterus, a woman has an increased likelihood of having a multiparous birth, meaning a twin or triplet birth.

As a woman ages, her chances of a successful pregnancy using this IVF method also change because her uterus and hormonal production are less able to support an implanted fertilized egg cell. This women’s fertility age chart from the CDC shows the ART success rates that were reported by fertility clinics in the U.S. in 2015 (source).

CDC’s 2015 ART Success Rates Leading to a Live Birth, with Nondonor Egg Cells

  • 31% in women younger than 35 years of age.
  • 24% in women aged 35 to 37 years
  • 16% in women aged 38 to 40 years
  • 8% in women aged 41 to 42 years
  • 3% in women aged 43 to 44 years
  • 3% in women older than 44 years of age

There are other methods of ART available to women, too. If a woman has a medical condition that makes it difficult for her to create egg cells for harvesting on her own, or a genetic condition she doesn’t want to pass along to her children, donor egg cells (egg cells harvested from another woman) can be used.

Additionally, because egg cell count and quality decreases with age, IVF can be performed using a woman’s egg cells that were previously frozen. This process, known as egg freezing—or cryopreservation—is a way of saving eggs harvested during a woman’s more fertile period, to be used at a later time.


Learn more about your own fertility and reproductive hormones using the Everlywell at-home Women’s Fertility Test, which lets you easily check 5 key hormones from the comfort of your home.


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What are the signs of infertility in women?


References

1. Female Age-Related Fertility Decline. American College of Obstetricians and Gynecologists. URL. Accessed April 13, 2020.

2. Women's life stages. Mayo Clinic. URL. Accessed April 13, 2020.

3. Sozou PD, Hartshorne GM. Time to pregnancy: a computational method for using the duration of non-conception for predicting conception. PLoS One. 2012;7(10):e46544. doi:10.1371/journal.pone.0046544

4. Your chance of pregnancy each month declines with age. American Society for Reproductive Medicine. URL. Accessed April 13, 2020.

5. Pregnancy after 35: Healthy moms, healthy babies. Mayo Clinic. URL. Accessed April 13, 2020.

6. Births: Final Data for 2018. Centers for Disease Control and Prevention. URL. Accessed April 13, 2020.

7. Infertility. Centers for Disease Control and Prevention. URL. Accessed April 13, 2020.

8. Infertility. Mayo Clinic. URL. Accessed April 13, 2020.

9. Age and Fertility. American Society for Reproductive Medicine. URL. Accessed April 13, 2020.

10. IVF Success Estimator. Centers for Disease Control and Prevention. URL. Accessed April 13, 2020.

11. In vitro fertilization (IVF). Mayo Clinic. URL. Accessed April 13, 2020.

12. Infertility FAQs. Centers for Disease Control and Prevention. URL. Accessed April 13, 2020.

13. Nagy ZP, Nel-Themaat L, Chang CC, et al. Cryopreservation of eggs. Methods Mol Biol. 2014;1154:439–454. doi:10.1007/978-1-4939-0659-8_20

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