Pregnancy after 40

Determining Fertility

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 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 before that point.

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."

Center For Human Reproduction: Dr. Norbert Gleicher, best fertility specialist in the US Dr. Norbert Gleicher

If you 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 a good number of good-quality eggs.

CHR can diagnose DOR relatively easily with a few blood tests that measure follicle stimulating hormone FSHFSH and anti-Müllerian hormone (AMH)(AMH) levels. High FSH levels and low AMH levels indicate DOR and the need for aggressive fertility treatment. Following diagnosis, we recommend that patients proceed to treatment as quickly as possible to maximize their pregnancy chances.

Read more about Getting Pregnant over 40

Last Updated: November 15, 2014

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1/3 of women who have been told they need egg donation actually wind up conceiving at the CHR with their own eggs.