The Honest Truth About IVF Over 40

It’s no secret that fertility declines with age. But knowing it and feeling the weight of it are two very different things.

You might be reading this after a conversation with your doctor, after a few unsuccessful months (or years) of trying, or maybe as someone proactively exploring your options. Regardless of where you are in your journey, let me just say this: you're not alone and you’re not without options. Let’s dive into the truth about IVF over 40, with equal parts science and hope.

How fertility changes after 40

By your 40s, chances are you’ve heard phrases like “biological clock” more than you’d care to count. And while it can feel frustrating to be reminded of time’s impact, there’s a scientific reason it's relevant. Female fertility declines gradually in the early 30s and more rapidly after 37, according to the American College of Obstetricians and Gynecologists (ACOG). By age 40, the chance of natural conception per cycle is only about 5%.

This decline is mainly due to egg quality and quantity. Women are born with all the eggs they’ll ever have, and both the number and quality decrease with time. Unfortunately, our ovaries don’t have repair mechanisms, so these changes are irreversible. As we age, the proportion of eggs with chromosomal abnormalities (called aneuploidy) increases, which can lead to decreased fertility, a higher risk of miscarriage, and an increased likelihood of genetic disorders.

In our late 20s, about 20% of eggs may be chromosomally abnormal. By age 40, that number climbs to nearly 60%, and by 44, it approaches 90%, per the Reproductive Medicine Associates (RMA) Network. While these statistics can feel discouraging, advances in assisted reproductive technology and individualized care have made it very possible for many women over 40 to achieve healthy pregnancies and successful births.

So, when should a woman in her 40s seek fertility support?

If you’re over 40 and trying to conceive, it’s a good idea to check in with a fertility specialist as soon as possible. While the general rule is to seek help after a year of trying under 35, or after six months over 35, many doctors suggest making that first appointment even earlier once you’re in your 40s.

Time is a key factor, and understanding your fertility status early on can empower you to make informed choices — whether that means moving forward with IVF, exploring other paths, or simply gaining peace of mind as you consider your next steps.

IVF after 40: what to expect

If you are considering IVF over 40, it’s important to know that IVF success rates do decline with age, but that doesn’t mean it’s not worth pursuing.

Dr. Adriana Wong, a Reproductive Endocrinology and Infertility fellow at the USC Keck School of Medicine practicing at HRC Pasadena, explains:

“Every case of fertility treatment should be individualized to the individual’s or couple’s family planning goals, medical history, and the results from the workup at that time, which is why it is worth undergoing a consultation and evaluation with a reproductive endocrinologist sooner rather than later. They can discuss recommendations and success rates that you might be able to expect.”

Per SART data, Dr. Wong shares almost every day with her patients, the average live birth rate per IVF cycle using a woman’s own eggs drops from about 26% at age 38 to around 13% at 41, and down to roughly 4% by age 44.

Still, some clinics and doctors have more experience and success at treating patients over 40, and if something doesn’t feel right to you, don’t hesitate to seek a second opinion. Everyone’s fertility story is different, and you deserve a care team that supports your family-building goals while providing realistic, evidence-based guidance.

Fertility options for women over 40

As you embark on your IVF journey, start by asking your doctor about any advancements in assisted reproductive technology (ART) and individualized treatment approaches that may help improve your chances of success.

Preimplantation genetic testing (PGT-A): This test screens embryos for whole chromosome aneuploidy before an embryo transfer, which is the primary cause of failed implantation and early miscarriage.

Egg donation: If your fertility specialist recommends it, using donor eggs from a younger woman can significantly increase IVF success rates in women over 40, with the average live birth rate per embryo transfer using donor eggs being about 39% for both fresh and frozen donor eggs.

Embryo banking: This involves undergoing multiple egg retrievals to create and freeze multiple embryos for future use. It’s a common strategy for women in their late 30s and early 40s who want to boost their chances over multiple IVF cycles.

Emerging treatments: Emerging treatments such as ovarian platelet-rich plasma (PRP) therapy are still considered experimental. While these options may offer hope, we are still awaiting more robust data to support their use.

The emotional reality of IVF in your 40s

Beyond the medical side, IVF is not just physically demanding — it’s emotionally exhausting, too. When you’re trying to conceive over 40, it can feel like the weight of every birthday, every failed cycle, and every “why did I wait?” thought is heavier. On top of that, you might be balancing a demanding job, caregiving, or navigating this journey solo.

If that’s you, I see you. You’re not “too old,” and it’s not “too late.” Whether you move forward with your own eggs, choose an egg donor, or consider embryo donation, every path is beautiful and deserving of support.

Remember: IVF over 40 is not without its hurdles, but it’s far from hopeless. With realistic expectations, the right medical team, and a strong support system, your dream of becoming a parent is still possible. You’ve got this!

Kristyn Hodgdon is a passionate women's health advocate and the Co-Founder and Chief Creative Officer of Rescripted, where she helps break down complicated medical info into content that's easy to understand — and actually helpful. As an IVF mom who’s experienced pregnancy loss and lives with PCOS, Kristyn blends her professional know-how with real-life experience to support others navigating similar journeys. Her work has been featured on Good Morning America, ScaryMommy, and more, and she’s the host of the podcast From First Period To Last Period. A Fordham University grad, Kristyn also volunteers with the Fly Again Foundation, which supports breast cancer patients. You can find her on Instagram or connect with her on Linkedin.