What Happens to Fertility After 40?
After age 40, both the quantity and quality of eggs decline more rapidly. The natural monthly chance of conception falls to roughly 5% per cycle, compared with 20-25% in your 20s. Miscarriage rates also rise, largely because of an increase in chromosomal abnormalities in eggs. That said, many women in their early 40s do conceive — and modern fertility care offers more options than ever, including donor eggs, which dramatically improve success at this stage.
Realistic Success Rates
Natural conception: around 5% per month at age 40, declining to under 1% by 45
IVF using your own eggs: roughly 10-15% live birth per cycle at 40-42, falling sharply after
IVF with donor eggs: 50-60% live birth per transfer regardless of recipient age
Cumulative success across multiple cycles is significantly higher than single-cycle figures
Outcomes depend heavily on individual ovarian reserve, uterine health and partner fertility
Steps to Take Now
Book a fertility specialist consultation without delay — at 40+, time is the most important variable
Request AMH, FSH and antral follicle count tests to assess ovarian reserve
Consider a uterine assessment (saline ultrasound or hysteroscopy) to rule out fibroids or polyps
Have your partner complete a semen analysis early in the workup
Discuss preconception health: optimise weight, stop smoking, limit alcohol, take folic acid
Explore all options openly — including donor eggs, embryo donation and adoption
When to Seek Help
If you are 40+ and considering pregnancy, see a specialist before you start trying or immediately
Do not wait the standard 6-12 months that applies to younger women
If you have irregular cycles, endometriosis, fibroids or previous pregnancy losses, seek help sooner
Early baseline testing gives you the most options and the best chance of success