Many women become pregnant and have healthy babies after age 35. However, fertility changes with age, so it can be helpful to approach pregnancy planning with clear information and a realistic timeline.

Seeking guidance does not mean that something is necessarily wrong. It allows you to identify potential concerns early and make informed decisions.

Why Fertility Changes With Age

Women are born with a finite number of eggs. Over time, both egg quantity and egg quality decline. Ovulation may remain regular, but the chance of conception during each cycle generally decreases with age.

The risk of miscarriage and chromosome-related conditions also rises gradually. Age is only one factor, though. Fertility may also be affected by:

• Ovulation disorders
• Endometriosis
• Fibroids
• Blocked fallopian tubes
• Previous pelvic infection
• Thyroid conditions
• Sperm-related factors
• Lifestyle and medical conditions

When Should You Request an Evaluation?

ACOG generally recommends a fertility evaluation after:

• 12 months of trying for women younger than 35
• Six months of trying for women older than 35
• A more immediate discussion for women older than 40

Earlier evaluation may be appropriate at any age if you have irregular periods, known endometriosis, previous pelvic surgery, recurrent pregnancy loss, or a history that may affect fertility.

What Can You Do Before Trying?

A preconception visit may include:

• Reviewing medications and supplements
• Discussing a prenatal vitamin with folic acid
• Updating recommended vaccines
• Managing diabetes, blood pressure, or thyroid disease
• Reviewing menstrual cycles
• Discussing genetic carrier screening
• Addressing tobacco, alcohol, or substance use
• Reviewing family and pregnancy history

Do not discontinue a necessary prescription medication without speaking with the prescribing clinician. Many health conditions are safest when they remain well controlled during pregnancy.

How Often Should You Try?

Having intercourse regularly throughout the cycle may be less stressful than trying to predict one exact day. Ovulation predictor kits can help when cycles are regular, but they may be more difficult to interpret for women with irregular ovulation or PCOS.

Tracking your cycle can still provide useful information for your appointment.

Fertility Care Should Include Both Partners

A fertility evaluation is not only focused on the woman. Sperm-related factors are common and may be evaluated early in the process.

Testing may include ovulation assessment, blood work, pelvic ultrasound, uterine or tubal evaluation, and semen analysis.

Planning With Confidence

Age-related fertility information should guide care, not create panic. Some women conceive quickly after 35, while others benefit from additional support.

Women’s Health and Menopause Center provides comprehensive gynecologic care and personalized pregnancy planning.

To discuss fertility concerns or prepare for pregnancy, schedule an appointment with our West Bloomfield OB-GYN team.

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