Getting Pregnant After 35: Your Chances and Your Timeline

Turning 35 doesn’t flip a switch on fertility, but it does change the advice. Fertility declines gradually through the early 30s and faster after 37, and guidelines shorten the time you should try before getting help from 12 months to 6. This guide gives the real numbers from a large study of people trying to conceive, explains why the threshold changes, and lists what to do now.

Can you get pregnant after 35?

Yes, and most people do. ACOG and ASRM say a woman’s fertility decreases gradually but significantly from about age 32, and more rapidly after 37.¹ That is a decline in the chance per month, not a cliff.

The best recent US data come from PRESTO, a study of 2,962 couples in the United States and Canada who had been trying for three cycles or less and had no known infertility.²

Unadjusted cumulative pregnancy proportions from the study’s Table 2; per-cycle ratios are adjusted fecundability ratios.² The study found fecundability fairly stable between 28 and 33 and an almost linear decline after that.² The 37 to 39 and 40 to 45 groups were small (141 and 38 women), so their numbers are less precise.²

Read the table as reassurance and urgency at once. About three in four women aged 34 to 36 were pregnant within a year. From 37, the chance per cycle drops more clearly, and every month counts for more.

Why does fertility decline with age?

Ovarian reserve, the number of eggs remaining, declines with age.⁵ ACOG and ASRM point to three things together: the expected decline in fertility, a higher rate of disorders that impair fertility, and a higher risk of pregnancy loss.¹

Egg number can be estimated with AMH, but egg quality cannot be tested directly. ASRM says ovarian reserve tests measure only quantity, and that age is a much stronger predictor of reproductive success than ovarian reserve.⁵

When should you see a doctor after 35?

After 6 months of regular unprotected sex without a pregnancy. ACOG and ASRM say women older than 35 should receive an expedited evaluation and treatment after 6 months of trying, or earlier if clinically indicated.¹ ASRM’s 2023 definition of infertility keeps the same 6-month threshold from age 35.³

Go sooner, without waiting 6 months, if you have irregular or absent periods, known or suspected endometriosis or tubal disease, a partner with a known sperm problem, or a history of chemotherapy or radiation.⁴ Over 40, get evaluated now: see getting pregnant after 40.

What does an evaluation include?

ASRM’s guidance covers ovulation, ovarian reserve (AMH or antral follicle count), thyroid, an ultrasound of the uterus, a test of the fallopian tubes and, at the same time, at least one semen analysis for a male partner.⁴ ASRM asks for the evaluation to be systematic, quick and cost-effective, starting with the least invasive tests for the most common causes, so most of it can be done within one or two cycles.⁴ Read when to see a fertility specialist for the full list.

Should you test AMH after 35?

An AMH test is common at this age, but it answers a narrower question than many people think. In a JAMA study of 750 women aged 30 to 44, women with low AMH had the same chance of conceiving within 6 and 12 cycles as women with normal AMH.⁶ ASRM says ovarian reserve markers should not be used as a fertility test for people who are not infertile, nor to promote planned egg freezing.⁵ High FSH made no difference either: 63% of women with FSH above 10 mIU/mL conceived within six cycles, against 62% with normal FSH.⁶ AMH is useful for planning IVF, because it predicts how many eggs stimulation may produce.⁵ See AMH explained.

What can you do now?

• Time sex to the fertile window. The days just before ovulation matter most; see the best time to have sex to conceive and the fertile window.
• Check your preconception basics, including a prenatal vitamin with folic acid; see the preconception checklist.
• Test the other partner early. The AUA/ASRM guideline says both partners should be assessed at the same time, with one or more semen analyses for the male partner.⁷ An at-home kit is a quick start; see semen analysis results.
• Know the male age question. In PRESTO, male age had little effect on fecundability after accounting for female age, though few men were over 45.² The AUA/ASRM guideline asks clinicians to tell couples that a father aged 40 or older carries an increased risk of some adverse health outcomes for children.⁷
• Decide your 6-month date. Write it down. If you aren’t pregnant by then, book the evaluation.

A simple six-month plan

1. Month 0. Note your start date. Check your cycles are regular (21 to 35 days). If they are not, book an appointment now rather than in six months.⁴
2. Months 1 to 3. Track ovulation and time sex to the fertile window. Arrange a semen analysis for your partner; it is quick and can be done at home.⁷
3. Months 3 to 6. Keep trying. Book the evaluation in advance so the appointment falls close to the six-month mark, since clinic wait times vary.
4. Month 6. If you are not pregnant, have the evaluation: ovulation, ovarian reserve, thyroid, uterus, tubes and the semen analysis together.⁴

If you turn 40 during this time, or learn of a known issue such as endometriosis, move straight to step 4.¹⁴

Thinking about egg freezing or IVF?

If you are not trying yet but want children later, egg freezing is an option to discuss with a specialist; ASRM says the decision should rest on your plans and age rather than an AMH result.⁵ See egg freezing cost. If you are already trying and treatment is on the table, IUI vs IVF and IVF cost cover the options. The Investigate hub has the rest.