TTC After 35: What Changes and What Helps
The honest truth about fertility over 35—plus science-backed strategies to maximize your chances.
Key Takeaways
- Fertility declines gradually after 30 and more noticeably after 35—but many people still conceive naturally
- Both egg quality and quantity decrease with age; this is the primary factor
- Supplements like CoQ10 may support egg quality (best started 3+ months before TTC)
- Seek fertility evaluation after 6 months of trying (not 12) when you're 35+
- Treatment success rates are still good in your late 30s—don't delay if you need help
If you're trying to conceive after 35, you've probably encountered alarming statistics and "geriatric pregnancy" terminology that feels unnecessarily dire. Let's take a breath.
Yes, fertility changes with age. But "advanced maternal age" starts at 35 simply because that's when we see measurable statistical differences—not because 35 is some magical cliff. Many people conceive naturally in their late 30s and early 40s. The key is understanding what's different, optimizing what you can, and seeking help at the right time.
This guide gives you the honest facts, practical strategies, and realistic hope you need.
The Reality of Fertility Over 35
Let's start with the numbers—not to scare you, but to give you realistic expectations.
Conception Rates by Age
| Age | Chance of Conceiving Per Cycle | Time to Conception (median) |
|---|---|---|
| Under 30 | 25-30% | ~3-4 months |
| 30-34 | 20-25% | ~4-5 months |
| 35-37 | 15-20% | ~5-7 months |
| 38-39 | 10-15% | ~7-10 months |
| 40-42 | 5-10% | ~12+ months |
| 43+ | <5% | Varies widely |
What These Numbers Mean
A few things to note:
These are averages. Some 38-year-olds conceive in their first cycle; some 28-year-olds take a year. Your individual fertility depends on many factors beyond age.
The decline is gradual. There's no cliff at 35. Fertility decreases slowly through your early 30s, then more noticeably in your late 30s, with a steeper decline after 40.
Most people over 35 still conceive naturally. The majority of people in this age group who want to get pregnant do—it may just take longer.
💚 The Bigger Picture
A large study in the journal Obstetrics & Gynecology found that among women 35-39 having sex during their fertile window, 82% conceived within a year. That's compared to 86% for women 27-34. The difference is real but not as dramatic as headlines suggest.
Why Age Matters for Fertility
Understanding the biology helps you make informed decisions.
Egg Quantity: You Were Born With Your Eggs
Unlike men (who produce new sperm constantly), women are born with all the eggs they'll ever have—about 1-2 million at birth. By puberty, this drops to about 300,000-400,000. By age 35, you have about 25,000 eggs remaining. By 40, about 3,000.
This is called "diminished ovarian reserve" and is measured by AMH (anti-Müllerian hormone) and antral follicle count.
Egg Quality: The Bigger Factor
More impactful than quantity is quality. As eggs age, they're more likely to have chromosomal abnormalities that lead to:
- Failure to fertilize
- Failure to implant
- Miscarriage (often caused by chromosomal issues)
- Chromosomal conditions like Down syndrome in viable pregnancies
At age 30, about 30% of eggs are chromosomally abnormal. At 40, it's closer to 60-70%. At 44+, it may be 90%+.
Other Age-Related Changes
- Shorter follicular phase: Cycles may become shorter and less predictable
- Lower response to fertility medications: If treatment is needed
- Higher risk of pregnancy complications: Gestational diabetes, preeclampsia, etc.
The Good News
You can't change your egg quantity. But emerging research suggests you may be able to support egg quality through lifestyle, nutrition, and targeted supplements. And if needed, fertility treatment remains highly effective for people in their late 30s.
How to Optimize Your Fertility Over 35
While you can't turn back time, you can optimize everything within your control. These strategies are especially important when time matters.
1. Perfect Your Timing
When every cycle counts, precise timing is crucial. Don't guess—track.
- Use OPKs daily starting 4-5 days before expected ovulation
- Monitor cervical mucus for early fertility signs
- Consider a fertility monitor for more detailed hormone data
- Have sex every 1-2 days during your fertile window
📱 Advanced Tracking for 35+
2. Prioritize Preconception Health
Start prenatal vitamins now. If you haven't already, begin immediately. Look for methylfolate (active form of folic acid), vitamin D, and ideally DHA.
Optimize body weight. Both underweight and overweight can affect fertility. A BMI between 18.5-24.9 is ideal, but even modest changes (5-10% of body weight) can help.
Limit alcohol. Keep consumption low—1-2 drinks per week maximum while TTC. Alcohol affects egg quality and hormone balance.
Quit smoking. Smoking accelerates egg aging and is linked to earlier menopause. If you smoke, quitting is one of the most impactful changes you can make.
Manage stress. Chronic stress can disrupt ovulation. Find sustainable stress-management practices—exercise, meditation, therapy, whatever works for you.
3. Eat for Fertility
Research supports a Mediterranean-style diet for fertility:
- Abundant vegetables, fruits, whole grains, legumes
- Healthy fats (olive oil, nuts, avocado)
- Fish (especially oily fish for omega-3s)
- Limited red meat; more plant proteins
- Limited processed foods and added sugars
The Harvard Nurses' Health Study found that women who followed a "fertility diet" had 66% lower risk of ovulatory infertility.
4. Exercise—But Not Too Much
Moderate exercise supports fertility. Extreme exercise (marathon training, intense daily workouts) can disrupt ovulation. Aim for 30-60 minutes of moderate activity most days: walking, swimming, yoga, strength training.
5. Get Your Partner Involved
Male factor contributes to 40-50% of fertility issues, and sperm quality also declines with age (though more gradually than egg quality). Encourage your partner to:
- Take a male fertility supplement
- Limit alcohol and quit smoking
- Avoid heat exposure to testicles (hot tubs, saunas, laptops on lap)
- Maintain healthy weight
- Get a semen analysis if TTC for 3+ months
Evidence-Based Supplements for Egg Quality
The book It Starts with the Egg by Rebecca Fett popularized the idea that supplements can support egg quality. Here's what the research says:
CoQ10 (Ubiquinol)
Why it may help: CoQ10 is essential for cellular energy production in mitochondria. Egg quality is closely tied to mitochondrial function, which declines with age. Supplementing may support the energy-intensive process of egg maturation.
Research: Animal studies show improved egg quality with CoQ10. Human studies in IVF patients have shown promising results, though more research is needed.
Recommended form: Ubiquinol (active form) is better absorbed than ubiquinone. Typical dose: 200-600mg daily.
Timing: Start at least 3 months before TTC, as eggs take ~3-4 months to mature.
🔋 CoQ10 Supplements
Jarrow Ubiquinol QH-absorb 200mg
Highly absorbable ubiquinol form. Third-party tested for quality. Widely recommended in TTC communities.
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~$25-35 for 60ct
Check Price on Amazon →Thorne Q-Best 100mg
Trusted brand with third-party testing. Good for those who prefer a lower dose to start.
~$40-50 for 60ct
Check Price on Amazon →NeoQ10 (Fertility-Specific)
Developed specifically for fertility. Patented form with clinical studies in IVF patients.
~$60-70
Check Price on Amazon →Vitamin D
Why it may help: Vitamin D receptors are present in the ovaries and uterus. Deficiency is linked to lower fertility and higher miscarriage risk.
Recommended: Get your levels tested. Many people are deficient. Aim for blood levels of 40-60 ng/mL. Typical dose: 2,000-4,000 IU daily, depending on baseline levels.
DHEA
Why it may help: DHEA is a hormone precursor that may support ovarian function in women with diminished ovarian reserve.
Important: DHEA should only be taken under medical supervision. It's a hormone and can have side effects. It's typically used for women with low AMH or poor response to IVF meds.
Other Antioxidants
Some research supports:
- Vitamin E: Antioxidant that may protect eggs from damage
- Vitamin C: Works synergistically with vitamin E
- Alpha-lipoic acid: Another mitochondrial support
- N-acetyl cysteine (NAC): Precursor to glutathione, a master antioxidant
Quality Prenatal with Methylfolate
Your prenatal vitamin forms your foundation. For 35+, look for:
- Methylfolate (not just folic acid)—better absorption
- Methylated B12
- At least 1,000 IU vitamin D
- DHA/omega-3s (or take separately)
- Choline (often under-dosed in prenatals)
💊 Premium Prenatals for 35+
Ritual Essential Prenatal
Methylated folate, choline, DHA, vitamin D. Delayed-release design is gentle on stomach. Subscription-based.
$35/month
Get 30% Off First Month →Thorne Basic Prenatal
Methylated B vitamins, iron-free option. Trusted for purity and quality testing.
~$42/month
Check Price on Amazon →FullWell Prenatal
Designed by a fertility dietitian. Comprehensive formula including choline and CoQ10.
~$59/month
Check Price on Amazon →➡️ Related: Best Prenatal Vitamins for TTC
⚠️ Supplement Caution
Supplements aren't magic—they support, not replace, overall health. Quality matters; choose third-party tested brands. Discuss with your doctor, especially if you're already seeing a fertility specialist or taking medications.
Testing Your Fertility
If you're 35+, consider getting baseline fertility testing even before you hit the 6-month mark. Knowledge is power.
Key Tests for Women
AMH (Anti-Müllerian Hormone): Measures ovarian reserve. Can be tested any day of your cycle. Lower levels suggest fewer eggs remaining—but doesn't necessarily predict natural conception ability.
Day 3 FSH and Estradiol: Elevated FSH can indicate diminished ovarian reserve. Tested on cycle day 2-4.
Antral Follicle Count (AFC): Ultrasound counting visible follicles. Part of ovarian reserve assessment.
Thyroid Panel (TSH): Thyroid dysfunction affects fertility and pregnancy. Optimal TSH for fertility is 1-2.5.
HSG: Checks if fallopian tubes are open. Usually done if TTC for 6+ months or if there's reason to suspect tubal issues.
At-Home Testing Options
Modern Fertility Hormone Test
Tests AMH, FSH, LH, TSH, and more from home. Results reviewed by physicians. Good starting point for understanding your fertility baseline.
~$179
Learn More →Everlywell Ovarian Reserve Test
Tests AMH and FSH for a snapshot of ovarian reserve.
~$99
Check Price on Amazon →What AMH Results Mean
| AMH Level (ng/mL) | Interpretation |
|---|---|
| Over 3.0 | High ovarian reserve (possible PCOS indicator if very high) |
| 1.0 - 3.0 | Normal/satisfactory ovarian reserve |
| 0.5 - 1.0 | Low-normal; may indicate diminished reserve |
| Under 0.5 | Low ovarian reserve; fertility treatment may be less effective |
Important: Low AMH doesn't mean you can't conceive naturally—it primarily affects treatment success. Some people with low AMH conceive without help; some with high AMH struggle. It's one piece of the puzzle.
When to Seek Help
The standard recommendation for people 35-39 is to see a fertility specialist after 6 months of trying. For those 40+, consider going after 3 months or even immediately.
Why Not Wait 12 Months?
Time matters more when you're older. Egg quality and quantity continue to decline, and treatment success rates decrease with age. Waiting an extra 6 months to seek help could meaningfully affect your options.
What "Trying" Means
Six months of "trying" means:
- Regular unprotected intercourse
- Timing sex during your fertile window
- Cycles are occurring (if you're not cycling, see a doctor right away)
When to Go Even Sooner
See a specialist right away if:
- You have irregular or absent periods
- You have a known condition (PCOS, endometriosis, fibroids)
- You've had previous fertility issues or miscarriages
- Your partner has known male factor issues
- You're 40+ and want to move quickly
➡️ Related: When to See a Fertility Doctor: Complete Guide
Treatment Options
If you need help, here's what treatment looks like for people 35+.
Timed Intercourse with Medication
Oral medications like Clomid or Letrozole stimulate ovulation, and ultrasound monitoring helps time intercourse precisely. Success rates: 10-15% per cycle.
IUI (Intrauterine Insemination)
Sperm placed directly in the uterus, usually with ovulation-stimulating medication. Success rates for 35-39: about 10-15% per cycle. For 40+: 5-10%.
IVF (In Vitro Fertilization)
Most effective treatment for age-related fertility decline. Success rates with own eggs:
| Age | Live Birth Rate Per Cycle (Own Eggs) |
|---|---|
| Under 35 | ~40-50% |
| 35-37 | ~30-40% |
| 38-40 | ~20-30% |
| 41-42 | ~10-20% |
| 43+ | ~5-10% |
IVF with PGT-A
Genetic testing of embryos before transfer can select chromosomally normal embryos, improving per-transfer success rates and reducing miscarriage risk. Particularly valuable for people 35+ when chromosome abnormality rates are higher.
Donor Eggs
If egg quality is the limiting factor, using eggs from a younger donor dramatically improves success rates. Success rates with donor eggs are based on donor age, not recipient age—typically 50-60% per cycle.
The Emotional Side
TTC over 35 carries unique emotional challenges. You're dealing with:
- Awareness of a "ticking clock"
- Possibly feeling like you're racing against time
- Medical language like "advanced maternal age" or "geriatric pregnancy"
- Well-meaning but stressful comments from family and friends
- The compounding stress of not wanting to "waste" cycles
Coping Strategies
Reframe the narrative. You're not "old"—you're informed and proactive. Many people build families in their late 30s and early 40s.
Control what you can, release what you can't. You can optimize your health, timing, and information. You can't control biology or outcomes.
Limit negative inputs. Reduce time on forums that amplify anxiety. Choose sources that inform without catastrophizing.
Get support. Consider therapy with a fertility-focused counselor. Connect with others in similar situations through RESOLVE or online communities.
Don't compare. Your journey is yours. Someone else's quick conception doesn't say anything about your path.
Frequently Asked Questions
Is 35 really a "cliff" for fertility?
No. 35 is when we see statistical changes, but the decline is gradual, not sudden. The steeper decline happens after 38-40. Many people conceive naturally in their late 30s.
Should I freeze my eggs if I'm not ready to have a baby?
If you're in your mid-30s and not close to TTC, egg freezing is worth considering. Success rates are higher with younger eggs. Consult with a fertility specialist to discuss your specific situation.
Can supplements really improve egg quality?
There's promising evidence, especially for CoQ10. Supplements won't reverse aging, but they may support mitochondrial function in developing eggs. Start 3+ months before TTC for maximum benefit.
What if I have low AMH?
Low AMH suggests fewer eggs remaining, but it doesn't predict natural conception ability well. You can still conceive with low AMH, especially if you're ovulating regularly. It's more relevant for IVF planning. Talk to a specialist about what your specific levels mean for you.
Should I skip to IVF given my age?
Not necessarily. Many people 35-39 conceive naturally or with minimal intervention. IVF is most appropriate when there's a specific indication (tubal issues, severe male factor, very low ovarian reserve, time pressure). A fertility specialist can help you decide the right approach.
What about pregnancy risks over 35?
Yes, pregnancy risks are slightly higher: gestational diabetes, preeclampsia, preterm birth, and cesarean delivery are all more common. But most people over 35 have healthy pregnancies. Good prenatal care is key.
You're Not Too Late
Yes, fertility changes with age. Yes, you may need to be more proactive than someone younger. But being 35+ doesn't mean your chance has passed—it means you should be informed, strategic, and willing to seek help when needed.
Many people in their late 30s and early 40s become parents. Some naturally, some with help, some through paths they didn't originally envision. All of these are valid journeys to parenthood.
Focus on what you can control: optimize your health, time intercourse well, take quality supplements, and don't hesitate to see a specialist if it's time. You're taking care of yourself—and your future baby—by being proactive.
You've got this. 💚