Across much of the globe, people are choosing to have children later in life now more than ever before. This shift is driven by a mix of factors including social, economic and cultural ones. There’s more acceptance of being child-free and prioritizing a career or other pursuits, and technology has enabled many to embrace parenthood according to their own timelines, if at all.
For example, in the U.S. the birth rate for women in their 30s now surpasses that of younger age groups, and births among women ages 35-39 have risen more than 70% since 1990. At the same time, advances in reproductive technology have made it safer and more socially acceptable to wait.
Yet, while these trends reflect empowerment and choice, they also underscore the importance of fertility awareness.
As modern life evolves, what about our biology has changed or remained the same for those pursuing children after 35? New research presented at the American Society for Reproductive Medicine (ASRM) Scientific Congress & Expo. and scientifically published in Fertility and Sterility provides meaningful outcomes for fertility and egg freezing at age 35 and older.
Fertility Over 35: Truths & Misconceptions
One thing we’ve all heard is that fertility declines as we age. And if you’ve been steeped in infertility content for a while, you’ve probably heard of the ‘fertility cliff’ – a concept demonstrating a slow decline in fertility until age 35, when a more pronounced drop occurs.
What might this look like? According to the American College of Obstetrics and Gynecologists (ACOG), the effects of fertility after 35 years old could impact:
- Egg quality: The rate of aneuploid (chromosomally abnormal) eggs increases with age. For example, at age 35 it’s estimated that 35% of eggs may be aneuploid; by age 40 that number reaches nearly 60%.
- Likelihood of Miscarriage: Research shows an increased risk of pregnancy loss with maternal age, i.e., the miscarriage rate in women in their 20s is estimated to be around 15% and rises to over 40% at age 40.
- IVF and Live Birth Rate: For IVF, the live-birth rate per cycle for women using their own eggs younger than 35 was approximately 41.5%; for women aged 35-37 it dropped to 31.9%; for older age groups lower still.
But where is the nuance? New research shows the decline is gradual, not a binary cutoff, so after 35 years old there is still a meaningful chance of conception, even though the rate of decline of egg health accelerates.
Jemma’s Story: One Woman’s Reality at 37
When Jemma started her first round of IVF at 37, she was cautiously hopeful, having frozen her eggs just after her 35th birthday. She knew it might take time. What she didn’t know, or wasn’t fully told, was how different the odds really were at her age.
After weeks of hormone injections, blood draws, and daily monitoring, the call finally came: three embryos made it to genetic testing. “It felt like a victory,” she told us. But a few days later, an email changed everything: all three embryos were chromosomally abnormal. None could be transferred. I didn’t expect that all of them would come back abnormal. It was hard to not feel like it’s my fault, that I’m somehow broken. I’ve been avoiding pregnancy my whole life, and now that I’m actually ready, I felt betrayed by my body for not being able to do the one thing I’ve been told I could do so easily.
“I took the call when I was leaving the grocery store, and I just froze right there on the sidewalk,” she said. “I didn’t even know what questions to ask. I thought at least one would be okay. I didn’t expect that all of them would come back abnormal. It was hard to not feel like it’s my fault, that I’m somehow broken. I’ve been avoiding pregnancy my whole life, and now that I’m actually ready, I felt betrayed by my body for not being able to do the one thing I’ve been told I could do so easily.”
At 37, it’s not uncommon for the majority of embryos to be aneuploid (containing too many or too few chromosomes) which prevents them from implanting or developing normally. Still, hearing that all her embryos were “abnormal” felt like a punch she never saw coming. “Having to tell the clinic to ‘discard’ them was so sad. It felt like a real loss, which also felt weird to be grieving just a bunch of cells. But those cells had potential.”
Now, Jemma is regrouping, physically and emotionally. She plans to try again, this time with a clearer understanding of what’s ahead. “I’m not giving up,” she says. “But I’m going in with open eyes. For me, it’s about balancing hope with real information. My partner and I didn’t really know how to express that grief with friends – how do you explain that you are grieving the potential of something?” For me, it’s about balancing hope with real information. My partner and I didn’t really know how to express that grief with friends – how do you explain that you are grieving the potential of something?”
Her story isn’t unique, but it’s one that too often goes untold. Behind every IVF cycle is a mix of science, emotion, and expectation, and for women like Jemma, transparency isn’t just a courtesy; it’s empowerment.
New Research on Preserving Your Fertility 35+ Reveals Promising News for Some
At pregnantish, we find immense hope in the steady stream of new research shaping the future of reproductive care. As infertility continues to be one of the fastest-growing areas in medicine, we’re grateful to the dedicated clinicians, lab experts, and researchers who push boundaries every day to develop new treatments and deepen our understanding of fertility. Their work reminds us that progress is not only possible, but happening right now.
US Fertility just published a new study with essential data for patients 35 and older. Results from 1,100 patients confirm that though live birth rates decrease steadily with age, there is encouraging evidence for successful outcomes for patients over 35, and even over 40.
Key findings include:
- The odds of live birth declined 21% with each advancing year of age at egg freezing.
- Patients aged 35-37 achieved live birth in nearly half of cases (49%).
- Patients aged 38-40 had a 32.5% live birth rate.
- Patients aged 41-42 achieved a 20% live birth rate.
- Even among those over 42, 13% achieved at least one live birth after thaw.
- Overall, 88.7% of eggs survived the egg thaw.
Source: US Fertility
This cohort study signifies the largest group of patients to return after egg freezing to thaw at ‘advanced’ maternal ages. The study analyzed data from 1,185 patients who froze eggs between 2013 and 2024 across the U.S.
By examining survival rates of thawed eggs, and live birth outcomes, US Fertility’s research provides new data for patients and clinicians making decisions about fertility preservation and IVF.
A REI’s Perspective On Fertility Over 35
We spoke with Reproductive Endocrinologist Dr. Ali Gannon of Shady Grove Fertility, who brought this research to life for us:
“Our research focuses on egg-freezing outcomes in women 35 and older, a rapidly growing population with limited data. Before our research, there wasn’t much published data for patients above the age of 42, so it was reassuring to see that even then, chances weren’t zero. We’re aiming to expand knowledge around outcomes in this group. Our research focuses on egg-freezing outcomes in women 35 and older, a rapidly growing population with limited data. Before our research, there wasn’t much published data for patients above the age of 42, so it was reassuring to see that even then, chances weren’t zero. We’re aiming to expand knowledge around outcomes in this group.
As it relates to the ‘fertility cliff,’ we’ve learned that fertility doesn’t suddenly drop at 35 – it’s a gradual decline. We know that success depends on age and egg count; someone with higher reserves at 40 may have better odds. Plus, technology is advancing quickly. Preimplantation genetic testing (PGT-A) has been a game-changer for women 38 and older, helping identify chromosomally normal embryos and improve success rates.
Every patient is unique. We tailor stimulation protocols and treatments to each person’s biology. I won’t sugar coat things – I tell patients the truth about their odds while holding hope for them, because you never know until you try. Fertility is deeply personal, emotional, and individual.
I have plenty of patients 35 and over who succeed. It may take more cycles, but there’s always hope. If you’re over 35, don’t wait more than six months before getting evaluated, and if you’re considering egg freezing, at least come in for a consultation to get the facts.
This work allows me to make a tremendous impact. You’re working with a vulnerable population, but you form incredibly intimate, rewarding bonds with patients.”
Where Science Meets Hope
Science can’t stop the clock, but it continues to redefine what’s possible. The growing body of research on fertility after 35 gives patients clearer data, better tools, and more options than ever before. For many, that knowledge is the difference between uncertainty and empowerment.
Fertility is not defined by a single number or age threshold – it’s shaped by knowledge, technology, and personal circumstance. While the data remind us that biology still matters, they also show that possibilities remain, especially when guided by evidence and individualized care.
As Dr. Gannon’s work and Jemma’s story illustrate, transparency is empowerment. Understanding the realities of reproductive aging doesn’t erase hope; it gives it context. The more information patients have, the better equipped they are to make decisions that align with their goals and to approach their journeys with both eyes open and hearts intact.
At pregnantish, we believe that every story is a reminder that behind every statistic is a person balancing reality and resilience. Hope may not always come easily, but it’s earned through courage, care, and the continued progress of science. Because – as we say at pregnantish – when science meets family, the possibilities are endless.
This article is presented by Shady Grove Fertility, a clinic in the US Fertility network. Shady Grove Fertility offers cutting-edge fertility treatments to help you grow your family. Explore the Shady Grove Fertility difference and their exclusive 100 percent refund for IVF at ShadyGroveFertility.com.
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