“Women are born with all the eggs they will ever have—about 1 to 2 million,” says Jane Frederik, MD, medical director of HRC Fertility of Newport Beach, CA. “Only about 400,000 of the eggs remain at the start of menstruation, which occurs around age 12." Frederik adds that a person’s amount of eggs continues to decrease as they age. “By the late 30s and 40s, the [egg] supply is low,” she says. “The decision to wait to have your first child can affect your fertility.” When it comes to learning about your fertility, there can be a lot to keep in mind at every age—from your odds of conceiving naturally in each decade to steps you can take to protect your health along the way.
Your Fertility in Your 20s
Your best odds to have a baby are in your 20s. One study found that women between the ages of 19 and 26 have a 50% chance of getting pregnant on any given month if they have unprotected sexual intercourse on the most fertile day of their menstrual cycle. The odds drop to 29% for women ages 35 to 39 face, according to the study. If you’re trying to get pregnant during your 20s, you can improve your odds by tracking your menstrual cycles. You can do this with an app, with body basal temperature monitoring, by observing changes in your cervical mucus, or by using ovulation predictor test kits. All of these methods will give you an idea of when you’re ovulating. This can help you time sex for the best odds of conception. Tracking your cycles is also a good way to detect any potential fertility problems. If you notice that your cycles are irregular, or you’re not showing signs of ovulation, speak to your gynecologist or healthcare provider. If you don’t get pregnant after one year of trying to conceive, you and your partner might choose to see a specialist for a fertility evaluation. While infertility is less common in younger couples, it can and does happen. Approximately 11% of couples face infertility, according to the National Institute of Child Health and Human Development. “For single women, women in same-sex relationships, individuals who identify as other than heterosexual, or those in relationships where spontaneously conceiving is not possible, any age is a reasonable time to consider a fertility consultation with a reproductive endocrinologist and infertility specialist to discuss fertility options,” explains Iris Insogna, MD, MBE, assistant professor of obstetrics and gynecology at the Columbia University Fertility Center. Regardless of when you hope to conceive—or even if you’re still unsure if you want to have a baby at all—it’s always a good idea to protect your fertility at any age. How? Some of the best things you can do include eating a healthy diet, avoiding smoking, and practicing safe sex when not trying to conceive. Sexually transmitted infections can sometimes lead to pelvic inflammatory disease (PID), which can be a cause of infertility. “There is very good data to show that women who have one episode of PID reduce their fertility by 12%,” says Mary Jane Minkin, MD, a clinical professor in the department of obstetrics, gynecology, and reproductive sciences at Yale Medical School. “Two episodes reduce it by 25% and three episodes by 50%.” Dr. Minkin suggests always using condoms, especially with new partners. “If you practice those healthy habits and then try to conceive at the soonest opportunity that works out for your social situation, you will optimize your chances of getting pregnant,” she says.
Your Fertility in Your 30s
Fertility generally begins to decline in your 30s. However, how steeply will vary on a case-by-case basis. “The changes that happen are very individualized,” explains Dr. Insogna. “They can be subtle, or they can be quite dramatic.” Because fertility begins to decline faster after age 35, most gynecologists recommend that you try to conceive for up to six months on your own. The age of a male partner can also impact your odds for conception. Male fertility declines with time as well, albeit at a slower rate than female fertility. If you don’t get pregnant after six months, and you’re over the age of 35, you might want to see your doctor for a fertility evaluation. Let’s say you’re approaching 35 and you’re still not ready to have a baby—but haven’t ruled it out entirely. This is when some people start thinking about egg freezing. At one time, egg freezing was used exclusively for patients who wanted to preserve their fertility prior to undergoing cancer treatment. However, it is becoming more common for people to freeze their eggs at a younger age in the event that they have trouble conceiving down the road. In that case, they can thaw their eggs and try to conceive with in vitro fertilization (IVF) treatment. With egg freezing, the younger you are, the more likely the eggs will be healthy and useful for conception later. Ideally, you should freeze your eggs before age 35, but there are a few other things to consider, like the cost, which can run past $20,000. Moreover, there is a chance you may never use your banked eggs, or you might not be able to successfully conceive with them. “It’s important to understand this procedure is like freezing the potential of having a future child with those eggs—but it is not a guarantee,” explains Dr. Insogna, adding that not all eggs survive the thawing process. Additionally, some fertilized eggs won’t turn into healthy embryos, and some eggs don’t fertilize at all. “Even if a woman has frozen her eggs, when she is ready to start a family, we recommend that she try on her own first [whether that be with a partner’s sperm or donor sperm],” she adds. “If she is struggling to become pregnant, then she could consider the frozen eggs as the backup plan.”
Your Fertility in Your 40s
Fertility continues to decline once a person hits age 40. Unlike the waiting periods associated with other ages, if you’re trying to conceive in your 40s, it’s a good idea to seek professional assistance right away. “I recommend finding a specialist for testing if the woman is age 40, in order to get to the successful pregnancy as soon as possible,” says Dr. Frederik. Some people might hope that they can turn to fertility drugs to get pregnant in their 40s. However, fertility treatment success rates are significantly lower for older couples. “Some insurance companies won’t even cover the cost of IVF for women over the age of 44 because the chances of conceiving using one’s own eggs are quite low,” says Dr. Insogna. Despite the reduced odds, there’s still hope. People can—and do—get pregnant in their 40s. While one in three individuals might experience infertility in their early 40s, that still means that two in three do not. If you froze your own eggs, using those in combination with IVF treatment can be an option for having a baby. If you did not freeze your eggs—or you did and the thawed eggs did not successfully lead to pregnancy—you could also consider donor eggs. “Pregnancy rates are very high using donor eggs, but it is a very personal decision and one that has to feel like the right choice for you,” says Dr. Insogna. Of course, pregnancy in your 40s comes with its own unique set of challenges. There can be more to consider than the method of conception alone. As noted by the American College of Obstetricians and Gynecologists (ACOG), becoming pregnant after the age of 35 can increase one’s risk of gestational diabetes, premature labor and birth, high blood pressure, and preeclampsia, along with the higher chance of miscarriage. That said, increased risk does not mean pregnancy is impossible, and many people in their 40s are able to conceive and have a successful gestation, labor, and delivery.
Your Fertility in Your 50s and Beyond
Can you have a baby in your 50s? Theoretically, with donor eggs and fertility treatments, yes—it’s possible. Menopause, which happens at around age 50 or 51, means your eggs are no longer viable or ovulating, but your uterus may still be fertility-ready. That said, it’s important to note that the odds of pregnancy complications are significantly higher at this age. “For women in their 50s, fertility is mostly limited to the use of donor eggs, or the use of previously frozen eggs or embryos,” explains Dr. Insogna. “Pregnancy is riskier as women age, with higher risks of hypertensive disorders including preeclampsia, gestational diabetes, C-section, etc.” ACOG’s guidelines surrounding pregnancy also concur that there are significant added risks for birthing people at this age, with suggestions for increased medical care throughout all trimesters. These guidelines include recommendations for detailed fetal anatomic ultrasonograms, antenatal fetal surveillance, ongoing nuanced counseling, prenatal genetic screening, and more. If you are considering trying to have a child with donor eggs or embryos in your 50s, or even after age 45, most fertility specialists recommend you first see a high-risk obstetric provider. While they can’t predict complications with complete accuracy, they can provide data and informed consent on the risks. Even if having a baby is no longer on the table, that doesn’t mean you can or should ignore your reproductive health at this age. Seeing your gynecologist or healthcare provider regularly is still important for your wellbeing even after menopause. “Pap smears and breast exams are important parts of preventative health care, which can easily be done by a gynecologist,” explains Dr. Insogna. “But they can also help coordinate other routine health screening such as mammograms and colonoscopies, and eventually DEXA [or bone density] scans.” Another reason to see your gynecologist is to help manage the symptoms of menopause, Dr. Insogna adds. “As women start to experience symptoms of menopause, they may find it helpful to consider various treatment options with their gynecologist to help alleviate those symptoms.”
A Word From Verywell
Your fertility changes as you age. While you may not be ready to have a baby when you’re in your super-fertile 20s, you can take steps to improve your odds of getting pregnant as you get older. Protecting your overall health, having safe sex, avoiding habits like smoking, and seeing a doctor if your cycles are irregular are all ways to take care of your fertility throughout your life. Also, remember that natural conception is only one option for parenthood. “Many options exist, including the use of donor eggs, donor sperm, donor embryos, gestational carriers, and, of course, adoption,” says Dr. Insogna. “It can be helpful to remember all of these options when considering how you might want to create your family, now or in the future.”
