For many women today, motherhood no longer follows a neat timeline. Careers, relationships, finances and personal readiness often mean that trying for a baby doesn’t begin until well into our 30s (or beyond!). Yet despite shifting social norms, anxiety around age and fertility remains as loud as ever.
Is fertility really at its peak before 30? Does turning 35 change everything? And is there still such a thing as a ‘best’ age to have a baby in an era of advanced fertility treatment and greater awareness of reproductive health?
To separate fact from fear, we spoke to Dr. Amit Shah, Consultant Gynecologist & cofounder of Harley St clinic Fertility Plus about what actually happens to fertility as we age, how realistic modern options like IVF and egg freezing really are, and what women can do to take a proactive (and empowering) approach to conceiving at any stage of life.
Conceiving past age 30, is there a ‘best’ age to have a baby anymore?
When it comes to the best age to conceiving, do you think there’s too much emphasis on age, rather than overall health and individual fertility?
Age is often used as a general indicator because, at a population level, it correlates strongly with egg quality and pregnancy outcomes. However, in clinical practice, age alone is never enough. Individual fertility varies widely. Overall health, ovarian reserve, hormonal balance and reproductive history are equally important. The key issue is not that age is discussed too much, but that it is often discussed without proper context or individual assessment.
What are the most common misconceptions you see about conceiving in your mid-to-late 30s?
One common misconception is that good physical health automatically means good fertility. Another is the belief that fertility declines slowly and predictably, when in reality the decline can be uneven and sudden. There is also an assumption that assisted reproductive technologies can completely overcome age-related changes, which is not accurate. While treatments can help, outcomes are still closely linked to egg quality.
How does fertility typically change between the early 30s, late 30s, and early 40s?
In the early 30s, most women have a good ovarian reserve and higher-quality eggs, with relatively high chances of natural conception. In the late 30s, both egg quantity and quality decline, leading to longer time to conception and increased miscarriage rates. In the early 40s, the decline becomes more pronounced, with significantly reduced chances of natural pregnancy and lower success rates with fertility treatments using one’s own eggs.
Are there habits you wish women would focus on earlier when it comes to protecting fertility?
Avoiding smoking, limiting alcohol, maintaining a healthy weight, managing stress and addressing hormonal or menstrual irregularities early are all important. Regular health check-ups and early evaluation of reproductive health can make a meaningful difference. Fertility preservation is often about preventing avoidable damage rather than reversing decline.
What does a healthy, proactive approach to fertility look like in your view?
A proactive approach involves understanding one’s reproductive health early, even before pregnancy is being planned. This includes awareness of menstrual patterns, timely investigation of any abnormalities and informed decision-making about family planning. It also means revisiting fertility plans periodically as life circumstances change.
Can fertility decline be slowed, or is it purely genetic?
Fertility decline is influenced by both genetics and lifestyle. Genetics determines the baseline and the natural pace of decline, but lifestyle factors such as smoking, obesity, untreated medical conditions, and chronic stress can accelerate it. While we cannot stop ageing, we can reduce factors that worsen its impact.
Who should realistically be considering egg freezing, and when is the ‘right’ time to do it?
Egg freezing may be appropriate for women who are not ready to conceive in their early to mid-30s but wish to preserve future options. It is also relevant for those facing medical treatments that may affect fertility. The most effective time is before a significant decline in egg quality, typically earlier rather than later.
At what point would you encourage women to seek advice rather than ‘waiting it out’?
Women under 35 should seek advice after 12 months of trying without success. Women 35 and over should seek help after 6 months. Immediate consultation is advisable for irregular cycles, known gynaecological conditions, or a history of pregnancy loss. Early evaluation allows for more options and better outcomes.
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