Determining Fertility


Fertility After 40 - Determining Pregnancy Chances

Medically reviewed by Norbert Gleicher, MD, FACOG, FACS - Written by CHR Staff - Updated on Aug 05, 2019

Determining Fertility In Your 40’s

The American Society for Reproductive Medicine (ASRM) recommends that women over age 35 consult a fertility specialist after six months of regular, unprotected intercourse that does not result in a pregnancy. Infertility is technically defined as failure to conceive in twelve months, but since the fertility window for older women is smaller, we recommend consulting with a doctor about fertility in your 40’s without waiting as long.

The ability of the ovaries to produce good-quality eggs (and ultimately good-quality embryos) declines with age, and practically all women by age 40 have lost enough of their ovarian reserve (OR) to qualify for a diagnosis of diminished ovarian reserve (DOR)At CHR, we consider all women above 40 to suffer from DOR and apply clinical protocols that individualize treatment to help women of advanced ages.

"A large majority of women who conceive at CHR were turned away by our colleagues."

Dr. Norbert Gleicher

Dr. Norbert Gleicher

If you are exploring your fertility in your 40’s but find yourself being treated the same way as the 25-year-old patient sitting next to you in the waiting room, we recommend that you reconsider your treatment plan. One of the many differences in treatment, for instance, is that older women require larger doses of fertility medications in order to produce enough good-quality eggs.

This does not mean that all women in their 40’s are the same in terms of their ovarian reserve, either. This is why CHR puts a strong emphasis on determining patients’ fertility in their 40s before devising an individualized treatment plan.


CHR can diagnose DOR relatively easily with a few blood tests that measure follicle stimulating hormone FSH and anti-Müllerian hormone (AMH) High FSH levels and low AMH levels indicate DOR and the need for aggressive fertility treatment. Following diagnosis, we recommend that patients seeking pregnancy in their 40’s proceed to treatment as quickly as possible to maximize their pregnancy chances, as ovarian reserve will continue its decline as time passes, making successful pregnancy more difficult.

Fertility in 40’s: Better Outcomes the Sooner You Start


Dr. Gleicher explains how a woman’s fertility in her 40’s changes and how CHR helps women to achieve pregnancy in their 40’s.


Egg Retrieval Over 40

Fertility potential at any age, particularly with fertility treatments, depends largely on how many eggs a woman can produce for egg retrieval, and how good the quality of those eggs are. Diminished ovarian reserve, which women over 40 almost always have, negatively affects both the quality and quantity of eggs, and ultimately their fertility potential. As women “use up” the eggs they were born with, by age 40, many women deplete their ovarian reserve and have difficulty producing enough good-quality eggs to make it to implantation, even with stimulation.

However, there are plenty of fertility success stories over 40 with women who use their own eggs to get pregnant at CHR. Our individualized treatment protocols suitable for each patient’s ovarian reserve status is an important part of our patients’ success. In recent years, CHR physicians pioneered the early retrieval or Highly Individualized Egg Retrieval (HIER) technique for women with DOR, which has also improved chances of fertility over 40, in some cases doubling the pregnancy rates with IVF.

Pregnancy at 50

Pregnancy at 50 is possible, but most women in their 50s require donor eggs to get pregnant. With HIER and individualized protocol, CHR’s fertility experts recently helped an almost-48-year-old patient conceive with her own eggs and deliver a healthy baby, demonstrating that pregnancy in women of very advanced maternal age is possible. As of 2019, she is the “oldest” patient ever reported in the literature to have delivered a healthy baby using her own eggs for IVF. However, we would advise a patient trying to get pregnant after 50 to consider donor eggs rather than their own eggs, as chances of pregnancy with their own eggs would be miniscule.

Pregnancy in over-40-year-olds with the patient’s own eggs is very possible, especially in women in their early and mid-40s. CHR has some of the highest pregnancy rates, particularly for women over 40. We believe in giving the woman all the information she needs to make an informed decision about her personal pregnancy chances after 40 (or after 50). At the end of the day, the decision to pursue pregnancy in your forties (or later) and how you’ll try to achieve that pregnancy, is up to you, and we are here to help.

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Norbert Gleicher, MD

Norbert Gleicher, MD, FACOG, FACS

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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