As an IVF specialist, this is one of the most common — and most confusing — questions I’m asked. It’s also emotionally loaded, because the answer has real-life consequences for couples planning a family. Let’s unpack this calmly, scientifically, and without blame.
Q1. Is it true that a woman’s fertility declines with age?
Yes. Unfortunately, female fertility is closely linked to age. A woman’s chances of conceiving naturally start to decline slowly after her late 20s, more noticeably after 35, and quite sharply after 40. This is not a medical opinion — it’s a biological fact.
Q2. What exactly changes as a woman gets older?
Two things decline with age:
- Egg quantity (ovarian reserve)
- Egg quality (genetic competence)
Women are born with all the eggs they will ever have — about 1–2 million at birth. By puberty, this drops to around 300,000. From then on, eggs are continuously lost every month, whether or not a woman tries to conceive.
By the late 30s and early 40s, not only are fewer eggs left, but a higher proportion of them have genetic errors, which reduces fertility and increases miscarriage risk.
Q3. Why are women born with a fixed number of eggs?
This is simply how human biology evolved. Egg production stops before birth, during fetal life. After that, the ovaries can only use eggs — they cannot make new ones.
This means the ovaries do have a biological clock, ticking away quietly in the background.
Q4. Why doesn’t the same rule apply to men?
Because male reproduction works very differently.
Men produce fresh sperm continuously throughout adult life. The stem cells in the testes keep dividing and making new sperm every day — even in old age. There is no fixed “sperm reserve” that runs out.
In simple terms:
- Women are born with eggs
- Men manufacture sperm daily
- That’s the core biological difference.
Q5. Does that mean men can father children at any age without problems?
Not exactly.
While men do not experience a sharp fertility “cut-off” like women, male fertility does decline gradually with age. Sperm count, motility, and DNA integrity can worsen over time. Advanced paternal age is also associated with a small increase in certain genetic and neurodevelopmental risks in offspring.
However, this decline is slow and linear, not sudden and steep — unlike female fertility.
Q6. Why is egg quality such a big issue compared to sperm quality?
Eggs are biologically more complex than sperm. They remain dormant in the ovaries for decades before ovulation. During this long resting period, they are vulnerable to:
- DNA damage
- Chromosomal errors
- Environmental stress
Sperm, on the other hand, are newly produced and short-lived. Fresh production means fewer accumulated errors.
This is why age-related infertility is driven primarily by egg quality — not by the uterus, hormones, or lifestyle alone.
Q7. Can lifestyle changes slow down ovarian ageing?
Healthy habits help overall reproductive health, but they cannot stop or reverse ovarian ageing.
Exercise, a balanced diet, avoiding smoking, and managing stress are all beneficial — but they don’t change the number or genetic quality of eggs a woman has.
This is an important point, because many women blame themselves unnecessarily. Biology is not a moral failing.
Q8. If a woman is healthy and menstruating regularly, does age still matter?
Yes. Regular periods only tell us that ovulation is happening — not whether the eggs are genetically normal.
Many women in their late 30s and early 40s have perfectly regular cycles but still struggle to conceive because egg quality has declined.
This disconnect is often surprising — and heartbreaking — but it’s common.
Q9. Does IVF overcome the problem of age-related fertility decline?
IVF helps, but it does not defy biology.
IVF can:
- Retrieve multiple eggs
- Improve fertilisation
- Allow selection of the best embryos
But IVF cannot make old eggs young again.
This is why IVF success rates also decline with female age — especially after 40.
Q10. What about donor eggs — why do they work so well?
Donor egg IVF works well because it replaces ageing eggs with younger, healthier ones. When a younger egg is placed in an older uterus, pregnancy rates remain high.
This clearly proves the central issue:
The uterus does not age as fast as eggs do.
Egg quality is the limiting factor.
Q11. Is this information meant to scare women?
Absolutely not.
My goal is not to frighten you — it’s to empower you with facts. When patients understand biology, they can make informed decisions that are right for them, whether that means trying naturally, freezing eggs, pursuing IVF, or choosing donor options.
There is no “right” decision — only an informed one.
Q12. What is the most important takeaway for couples?
Time matters — especially for women. Ignoring this reality doesn’t make it go away.
Understanding age-related fertility decline allows couples to:
- Plan earlier
- Seek help sooner
- Avoid unnecessary tests and treatments
- Reduce emotional and financial stress
- Knowledge doesn’t take away hope — it replaces false hope with realistic optimism.
Please get your doubts resolved free using our chatbot which is powered by AI based on Dr Malpani’s 40 years of clinical expertise and experience at https://www.drmalpani.com/chat-w-chatbot/index.html. This will ensure you’re on the right path and potentially save significant costs in the long run.