Getting pregnant after 35: your chances, practical steps and when to get help

How fertility changes with age

You're born with all the eggs you'll ever have. Over time, both the number and the quality of eggs decline. This decline becomes more noticeable from the mid-30s and speeds up after 40.

In practice, this means it may take longer to get pregnant, and the chance of miscarriage is higher. But many people conceive naturally in their late 30s and some in their early 40s. Age is just one factor — your overall health, any medical conditions and your partner's fertility matter too.

Sperm quality also declines with age, though more gradually, so it's a shared picture.

Steps to improve your chances

• Take folic acid every day, ideally from before you start trying until 12 weeks of pregnancy, to help prevent neural tube defects. Your doctor or pharmacist can advise on the right supplement for you.
• Have regular sex, every two to three days through your cycle, so there's always sperm present when you ovulate. Timing sex only around ovulation can add pressure without much benefit.
• Get to know your cycle — ovulation usually happens around two weeks before your period starts.
• Look after your health — stop smoking, cut back on alcohol, eat a balanced diet, stay active and aim for a healthy weight.
• Review your medicines with a doctor, especially for long-term conditions, before you try.
• Check your vaccinations and cervical screening are up to date.

When to see a doctor

General guidance is:

• Under 35: see a doctor if you haven't conceived after a year of regular sex.
• 35 to 39: see a doctor after six months of trying.
• 40 and over: speak to a doctor before you start trying or soon after.

See a doctor sooner, whatever your age, if you have irregular or absent periods, very painful periods, a history of pelvic infection, endometriosis or PCOS, previous cancer treatment, or if your partner has known fertility problems.

Tests may include blood tests to check hormones and ovulation, an ultrasound, a check of your fallopian tubes, and a semen test for your partner.

Fertility treatment options

Depending on the cause, options may include medicines to help you ovulate, intrauterine insemination (IUI), IVF, or using donor eggs. Success rates for IVF using your own eggs fall with age, while donor eggs from younger donors can offer higher chances. Access and funding vary a lot by country and region, so ask your doctor what's available and what the waiting times are.

If you're not ready to try yet, egg freezing is an option some people consider. It works best at younger ages and doesn't guarantee a future pregnancy, so it's worth discussing realistic expectations with a specialist.

Pregnancy after 35: what to expect

Most people over 35 have healthy pregnancies and babies. However, the chances of some complications are higher, including miscarriage, chromosomal conditions such as Down's syndrome, gestational diabetes, high blood pressure and pre-eclampsia.

You'll be offered screening tests during pregnancy, and you can decide which ones you want. Attending your antenatal appointments helps spot and manage any problems early.

Looking after your wellbeing

Trying to conceive can be emotionally draining, especially if it takes longer than you hoped. Talking to your partner, friends or a counsellor can help, and many fertility clinics offer support. You're not alone, and it's okay to feel however you feel.

Get urgent help if

If you're pregnant or might be, get urgent medical care for severe pain in your tummy, pain in the tip of your shoulder, heavy bleeding, or feeling faint or dizzy. These can be signs of an ectopic pregnancy, which needs emergency treatment.