Age And Fertility

Overview

Age and fertility describes how a person's ability to get pregnant naturally changes as they get older. Fertility means the ability to conceive a baby. For women, fertility starts to decline from around age 30, and more quickly after 35. For men, sperm health also slowly declines with age, but this happens more gradually.

Yes. Many people today choose to have children later in life, and age-related fertility decline is a common concern. Around 1 in 7 couples struggle to conceive at some point, and age is one of the main reasons.

It affects both women and men. Women experience a more noticeable decline because of the natural ageing of their eggs. Men also see changes in sperm quality, but the effect is generally less and happens later.

Symptoms

Common symptoms

• No pregnancy after trying for a year (or 6 months if you are over 35).
• Changes in your menstrual cycle, such as shorter, longer, or skipped periods.
• Signs of hormonal changes, such as hot flushes or night sweats in women in their late 30s or 40s.

Symptoms in children

• This topic does not apply to children. Fertility begins after puberty.

Symptoms in older adults

• For women approaching menopause: irregular periods, hot flushes, and mood changes.
• For men: possible reduced sex drive, fatigue, or erectile changes, though these are not specific to fertility.

Causes

Main causes

• Natural ageing of eggs in women, reducing both their number and quality.
• Hormonal changes as women approach menopause, including reduced levels of key hormones.
• In men, a gradual decline in testosterone and sperm quality with age.

Risk factors

• Being over 35 (for women) or over 40 (for men).
• Smoking, heavy alcohol use, and recreational drug use.
• Being very underweight or overweight.
• Medical conditions such as endometriosis, polycystic ovary syndrome (PCOS), or diabetes.
• Certain cancer treatments, including chemotherapy or radiation, can affect fertility.

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.

Book a routine appointment if:

• If you are under 35 and have not conceived after 12 months of regular, unprotected sex.
• If you are 35 or older and have not conceived after 6 months.
• If you have irregular, missed, or painful periods.
• If you or your partner have a known condition that can affect fertility, such as endometriosis, PCOS, or a low sperm count.
• If you have a history of pelvic infections, surgeries, or miscarriages.

Diagnosis

A doctor (usually a GP) will start by talking with you or your partner about your medical history, your menstrual cycle, and how long you have been trying to conceive. They may then arrange simple tests to check for common causes.

Tests that may be done

• A semen analysis for the man, to check sperm count, movement, and shape.
• Blood tests for the woman, to check hormone levels that control ovulation and egg supply.
• An ultrasound scan of the womb and ovaries, sometimes called a pelvic ultrasound.
• Sometimes, a test called an HSG (hysterosalpingogram) to check if the fallopian tubes are open.

What to expect at your appointment

The process is gentle and step by step. Your doctor will explain each test and what the results mean. You and your partner will be involved in all decisions. If more specialised care is needed, you will usually be referred to a fertility specialist.

Treatment

Treatment depends on the cause, the age of both partners, and how long you have been trying. Many lifestyle changes can improve your chances, and medical treatments range from simple medicines to assisted conception like IVF. Some people may also choose to use donated eggs or sperm.

Self-care at home

• Track your menstrual cycle to identify your most fertile days, especially the few days before and around ovulation.
• Have regular sex (every 2–3 days) without using contraception, and do not worry too much about timing every single time.
• Stop smoking, limit alcohol, and avoid recreational drugs.
• Keep a healthy body weight – being too underweight or overweight can affect ovulation and sperm quality.

Medical treatments

Medical treatments may include fertility medicines that help eggs mature and be released, procedures where sperm is placed directly into the womb (intrauterine insemination), and assisted conception such as IVF, where eggs are collected, fertilised in a laboratory, and then placed in the womb. Your doctor will discuss which options might be suitable for your age and circumstances.

When is surgery considered?

Surgery is sometimes needed to treat conditions that block normal conception, such as endometriosis, fibroids, or blocked fallopian tubes. Any operation would be discussed in detail with a specialist.

Living with this condition

Living with fertility concerns can be emotionally tiring. It is helpful to go through the process with your partner or a trusted friend, and to take breaks when the journey feels overwhelming. Keep a routine and focus on activities that bring you calm.

Lifestyle tips

• Plan your days with time for rest and hobbies.
• Talk openly with your partner about how you are both feeling.
• Avoid using alcohol or tobacco as ways to cope.
• Try gentle exercise like walking, yoga, or swimming to reduce stress.

Diet and exercise

Eat a varied diet with plenty of fruit, vegetables, whole grains, and protein. A daily vitamin supplement containing folic acid is often advised for women, especially before pregnancy. Ask your doctor or pharmacist what they recommend. Keep physical activity moderate and regular – extreme exercise can disrupt cycles.

Mental health and emotional wellbeing

Struggling to conceive can bring sadness, anxiety, guilt, or anger. These feelings are normal and part of many people's journey. It is important to acknowledge them and seek support if they become overwhelming. Talking to a counsellor does not mean you are failing; it is a helpful step.

Prevention

You cannot prevent the natural ageing of your eggs or sperm. However, you can protect your fertility by keeping a healthy lifestyle, avoiding smoking, and attending regular health check-ups. For some women, egg freezing before age 35 is an option to preserve fertility for the future – this is something to discuss with a fertility specialist.

Vaccines

Keeping your vaccinations up to date, for example rubella (German measles), can protect you and a future pregnancy. Routine vaccines are available through your local health service – ask your nurse or pharmacist.

Screening programmes

Regular screening for sexually transmitted infections and cervical screening (a smear test) can help protect your fertility. If you have an STI, treating it early can avoid damage to the fallopian tubes.

Complications

If left untreated

• If fertility concerns are not discussed with a doctor, you might delay access to treatments that could help.
• Emotional stress and relationship strain can build if you face fertility difficulties alone.
• Underlying conditions, such as endometriosis or blocked tubes, may get worse if not evaluated.

Long-term outlook

There is always reason for hope. Fertility declines with age, but many people still conceive naturally or with treatment. The care available today, from simple medicines to IVF and donor conception, has helped millions of people become parents. The earlier you start asking questions, the more options you are likely to have.

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