Review a clinic About NHS eligibility calculator Match to clinic

Can You Get Pregnant During Perimenopause?

It’s a common question: can you get pregnant during perimenopause? The reality is that while fertility becomes less predictable, ovulation can still occur, and pregnancy remains possible. For some, this happens naturally, while others explore treatments like IVF to improve their chances.

Tassia O'Callaghan profile

Author

Tassia O’Callaghan

Reviewed by

Kayleigh Hartigan

17 min read

Published 24 October 2025

Spotlight:

  • Perimenopause is the transitional phase before menopause, marked by fluctuating hormones, irregular cycles, and symptoms such as hot flashes and sleep changes.

  • It usually begins in the mid-to-late 40s, though it can start earlier in the late 30s, and lasts until menopause (12 months without a period).

  • Fertility declines but doesn’t disappear — ovulation may still occur, meaning pregnancy is possible, though less likely.

  • Natural conception becomes harder with age: around 75% chance within a year at 30–34, falling to 44% at 40+, with lower success into the mid-40s.

  • Lifestyle support, medical guidance, and fertility treatments (such as IVF or donor egg IVF) can improve the chances of conceiving during perimenopause.

  • Pregnancy in perimenopause carries higher risks, so professional monitoring and early support from a GP or fertility specialist are essential.

What is perimenopause?

Perimenopause is the natural transition phase before menopause, when the ovaries gradually produce less oestrogen and progesterone. These hormonal shifts affect the menstrual cycle, often making periods shorter, longer, lighter, or heavier than you’ve been used to. You might also notice new symptoms such as hot flashes, night sweats, mood changes, or disrupted sleep. [1]

This stage can last several years — for some, as little as four, for others closer to a decade. It’s important to remember that menopause itself isn’t reached until you’ve gone 12 consecutive months without a period. Until then, ovulation can still take place in some cycles, which means pregnancy is still possible.

For those actively trying to conceive, understanding perimenopause is about more than recognising symptoms: it’s about knowing that while fertility naturally declines, it doesn’t vanish overnight. Tracking your cycle and getting support from a healthcare professional can help you make sense of what’s happening in your body and explore the options available.

What’s the average age for perimenopause to start?

Perimenopause usually begins in the mid-to-late 40s, though it can start earlier for some, even in the late 30s. Genetics, health, and lifestyle all influence timing. Because the range is wide, changes in your cycle or new symptoms aren’t always easy to interpret — which is why checking in with a healthcare professional can help confirm whether you’ve entered perimenopause. [1]

Find the right clinic for you

Choosing a clinic is one of the biggest decisions you’ll make. We’ll find the best options for you and arrange your pre-treatment tests, empowering you from this point onwards.

Find my Match

How to get tested for perimenopause

There isn’t a single “yes or no” test for perimenopause, and in most cases diagnosis is based on your symptoms and cycle changes rather than lab results. If you’re over 45 and have typical signs such as hot flashes, night sweats, or changes in your period pattern, a GP is usually able to identify perimenopause without the need for blood tests.

For people aged 40–45, or if your symptoms are less clear, a doctor may arrange blood tests to check follicle-stimulating hormone (FSH) levels. Two tests, taken 4–6 weeks apart, can help confirm whether ovarian function is declining. Blood tests may also be considered if menopause is suspected in younger people under 40 (to rule out premature ovarian insufficiency), or if you’re over 50 and using progestogen-only contraception, since periods won’t be a reliable marker. [2]

It’s important to know that FSH results can be unreliable if you’re taking hormonal contraception, HRT, or tamoxifen, so in these cases a specialist referral may be recommended instead. If you’ve had a hysterectomy, diagnosis will also be based on symptoms rather than periods.

Because perimenopause can look different for everyone — and can arrive earlier in some groups, such as people from certain ethnic minority backgrounds or those with lifelong conditions like Down’s syndrome — it’s best to speak with a GP or menopause specialist if you’re unsure. They can review your symptoms, arrange appropriate tests, and guide you on what’s happening in your body. [2]

Are you still fertile during perimenopause?

Yes — but fertility is reduced. During perimenopause, the ovaries don’t follow the same predictable pattern they once did. Some months you may still release an egg, while in others ovulation doesn’t happen at all. When ovulation does occur, the quality of the remaining eggs is generally lower, and hormonal changes can make the uterine lining less receptive to implantation. [3,4]

All of this means that the chance of conceiving naturally is smaller than in earlier reproductive years, but it isn’t zero. Pregnancies do still happen during perimenopause, sometimes unexpectedly and sometimes through careful tracking or treatment.

Understanding that fertility doesn’t disappear overnight can be empowering. If you’re hoping to conceive, it highlights the importance of monitoring your cycles, seeking professional guidance, and exploring supportive options — from lifestyle changes to fertility treatments — that can maximise your chances.

Do you still ovulate in perimenopause?

Ovulation doesn’t stop all at once — it tapers off gradually. In perimenopause, your cycle becomes less predictable, which means some months you may still release an egg, while in others ovulation doesn’t occur at all (known as an anovulatory cycle). [5]

Even when ovulation happens, the timing can shift from what you’re used to. Instead of a steady mid-cycle pattern, it may happen earlier, later, or not at all in a given month. This unpredictability is one of the main reasons fertility declines during perimenopause, but it also explains why pregnancy is still possible until menopause is complete.

For those trying to conceive, this means identifying ovulation requires more than just counting cycle days — tracking hormone levels, using ovulation tests, or having ultrasound monitoring can give a clearer picture of when (and if) ovulation is taking place.

How do I know what stage of perimenopause I'm in?

Perimenopause unfolds gradually, and recognising the stage you’re in can help you understand both your symptoms and your fertility. Here’s how the transition typically looks (although there aren’t any clinically recognised standards for stages of perimenopause):

Early perimenopause

  • Cycles shorten by a few days (for example, going from a regular 28 days to 24–26).
  • PMS symptoms may feel stronger or last longer.
  • Periods may become heavier, with more clotting or cramping than usual.
  • Fertility is lower but ovulation still occurs more often than not.

Mid perimenopause

  • Cycles start to lengthen — sometimes stretching to 35–60 days.
  • Hot flashes, night sweats, and sleep disruption often appear.
  • Periods may vary widely in flow, from very heavy to unusually light.
  • You may begin to notice missed ovulations in some cycles.

Late perimenopause

  • Long gaps between periods (skipping two or more cycles in a row).
  • Symptoms like hot flashes, vaginal dryness, or mood swings become more persistent.
  • Periods are irregular and less frequent, with ovulation becoming rare.

Menopause

  • Officially reached after 12 consecutive months without a period.
  • The ovaries no longer release eggs, and natural pregnancy is no longer possible.
  • Some symptoms may ease, while others (like vaginal dryness) may continue.

Blood tests such as FSH, AMH, and estradiol, alongside ultrasound scans, can add clarity — but since hormone levels fluctuate, combining test results with symptom tracking often gives the most accurate picture. [6]

What are the chances of getting pregnant during perimenopause?

Natural conception during perimenopause is less likely, but it isn’t impossible. Fertility depends on both the number of eggs remaining and their quality, both of which decline steadily with age. Irregular ovulation and hormone shifts add another layer of unpredictability, which is why conception rates drop more sharply in the 40s.

Here’s how the likelihood of pregnancy compares by age: [7]

  • Age 30 or under: Around 85% chance to conceive within 12 months.

  • Age 30–34: Around 75% chance to conceive within 12 months.

  • Age 35–40: Around 66% chance to conceive within 12 months.

  • Age 40+: Around 44% chance to conceive within 12 months (then declining with age)

These figures show that fertility doesn’t switch off overnight — it decreases progressively. While the odds in perimenopause are lower, pregnancy does still happen, both unexpectedly and with the support of fertility treatment. If you’re actively trying, understanding the numbers can help you make informed choices about whether to continue naturally or seek medical support.

Your NHS Eligibility

Use our NHS IVF Eligibility Calculator to discover if you can access free IVF and IUI.

Check my eligibility now

How to get pregnant during perimenopause naturally

Conceiving during perimenopause can be more challenging, but there are still steps you can take to support your chances. The most important first step is to speak with a medical professional — whether that’s your GP, a gynaecologist, or a fertility doctor at a clinic. They can guide you through the right investigations, help you understand your options, and make sure your approach is safe and tailored to your needs.

Some of the areas they may suggest exploring include:

  • Tracking ovulation: Identifying when (and if) you’re ovulating is key, using methods like ovulation predictor kits (LH strips), basal body temperature tracking, and cervical mucus tracking. [8]

  • Supporting egg health: Maintaining a balanced diet, reducing alcohol, and moving your body regularly may all help create the healthiest possible environment for conception. [9]

  • Timing sex: Fertility is lower in perimenopause, but pregnancy is still most likely to happen if sex takes place close to ovulation — AKA your “fertile window.”

  • Have a pre-conception check-up: A GP or fertility specialist can run simple tests (like hormone levels, thyroid checks, or a pelvic scan) to make sure there aren’t underlying issues that could affect fertility.

  • Maintain a healthy weight: Being significantly underweight or overweight can disrupt ovulation and hormone balance, so aiming for a healthy BMI (or whatever is healthy for you and your body) can improve your chances. [10]

  • Look after your mental health: Stress can interfere with cycle regularity and ovulation. Relaxation techniques such as yoga, mindfulness, or counselling may help reduce stress levels and support overall wellbeing. [11,12]

  • Stop smoking: Smoking accelerates egg loss and reduces fertility at every age, making it particularly important to quit during perimenopause. [13]

  • Limit caffeine and alcohol: Both can affect hormone levels and egg quality if consumed in high amounts. Moderation is key. [14]

  • Get enough sleep: Poor sleep is linked to hormonal imbalance, so aiming for 7–9 hours a night can support reproductive health. [15]

  • Check medications: Some prescription or over-the-counter medicines can affect fertility. A GP or pharmacist can review these and suggest safer alternatives if needed.

  • Supplements: Some people are advised to take vitamins such as folic acid, vitamin D, or CoQ10, though what’s right for you will depend on your health and medical history. We don’t advise starting any new supplements without the recommendation of a medical professional — some supplements can have a negative impact on your trying to conceive journey. [16,17,18]

Because fertility in perimenopause looks different for everyone, professional guidance is essential. It can give you clarity, save valuable time, and ensure you have support as you try to conceive.

How long should I try before seeking medical advice?

If you’ve been trying to conceive for a year without success, it’s recommended that you see your GP for an initial fertility assessment. Because fertility naturally declines with age, you should make an appointment sooner if you’re 36 or over, if your cycles are irregular, or if you have a medical history that could affect fertility — such as previous cancer treatment or a past STI. [19]

Fertility tests can take time, and getting started early can make a real difference, especially during perimenopause. Your GP can arrange the first round of investigations for both you and your partner, since fertility issues can affect either or both, and then guide you on next steps.

If you prefer not to wait for NHS referrals or local ICB decisions, you may choose to approach a private fertility clinic directly, where investigations can usually begin more quickly. Whether you continue trying naturally for a little longer or move forward with treatment, seeking support early is about more than maximising your chances — it’s also about reassurance, clear guidance, and having a plan during what can be an emotional and sometimes overwhelming process.

Can you get pregnant on HRT?

Many people in perimenopause take hormone replacement therapy (HRT) to manage symptoms such as hot flashes, night sweats, mood changes, or irregular bleeding. It can be an effective way to improve quality of life during this transition — but it’s important to understand how it relates to fertility.

HRT is not a form of contraception, so pregnancy is still possible if you’re ovulating while taking it. Sequential combined HRT — prescribed under brand names such as Evorel Sequi, Elleste Duet, Femoston, or Novofem — should not be taken if you are pregnant or think you might be, and you should stop and speak to your doctor straight away. [20]

Find the right IVF clinic for you

Choosing a fertility clinic is a big decision – and we’ve made it clearer.

Get Matched

How does perimenopause affect fertility treatment?

Fertility treatments during perimenopause can look different depending on your age, ovarian reserve, and overall health. Here are the most common options:

IVF with your own eggs

IVF may still be possible during perimenopause, but success rates are lower because egg numbers and quality decline with age, and ovulation becomes less predictable. In many cases, higher doses of medication are needed to stimulate the ovaries, though the response can vary greatly from person to person. [21]

There has been some discussion about whether ovarian stimulation in IVF could bring on menopause sooner. Research suggests that while IVF may be linked to a slightly earlier onset of menopause and more urogenital symptoms, the overall impact is small and not considered clinically significant. In other words, IVF itself does not cause early menopause — it more often reflects an already reduced ovarian reserve in those who need treatment. [22]

For anyone in perimenopause considering IVF with their own eggs, it’s important to know that while pregnancy is possible, success rates are lower compared to younger age groups. A fertility specialist can assess ovarian reserve with tests like AMH and antral follicle count to give a clearer picture of whether this route is a realistic option, although it’s worth noting that there aren’t any tests for egg quality at this time.

Success rates of IVF with own eggs by age according to the HFEA: [23]

  • Age 18 to 34: 43% pregnancy rate, 35% birth rate
  • Age 35 to 37: 38% pregnancy rate, 30% birth rate
  • Age 38 to 39: 32% pregnancy rate, 24% birth rate
  • Age 40 to 42: 24% pregnancy rate, 17% birth rate
  • Age 43 to 44: 15% pregnancy rate, 10% birth rate
  • Age 44 and up: 14% pregnancy rate, 10% birth rate


Donor egg IVF

Donor egg IVF is often the most effective fertility treatment during perimenopause, as it bypasses the challenges of diminished egg quality and irregular ovulation. Using eggs from a younger donor significantly increases the chances of conception, regardless of the recipient’s age. Studies have shown that pregnancy rates with donor eggs remain steady across age groups — with clinical pregnancy rates around typically over 40% per embryo transfer. In fact, one study found the oldest recipient to successfully deliver with donor eggs was 54 years old. [24,25]

This consistency is why many clinics recommend donor egg IVF for people in their 40s and 50s. While success rates are higher, it’s also important to acknowledge the emotional, ethical, and practical considerations. For some, the reassurance comes from understanding that carrying the pregnancy still provides a strong biological and emotional bond, even if the egg is from a donor. [26,27,28,29,30]

Success rates of IVF with donor eggs by age according to the HFEA: [23]

  • Age 18 to 34: 44% pregnancy rate, 39% birth rate
  • Age 35 to 37: 45% pregnancy rate, 36% birth rate
  • Age 38 to 39: 43% pregnancy rate, 32% birth rate
  • Age 40 to 42: 45% pregnancy rate, 38% birth rate
  • Age 43 to 44: 47% pregnancy rate, 35% birth rate
  • Age 44 and up: 42% pregnancy rate, 33% birth rate

 

IUI (intrauterine insemination)

IUI is rarely recommended in perimenopause because cycles are often irregular, making it difficult to time insemination accurately. While it may be considered if you’re still ovulating fairly consistently and your fallopian tubes are open, many clinics move straight to IVF or donor egg IVF for more reliable outcomes. [31,32]

Studies show that IUI success rates decline sharply with age. For women under 35, clinical pregnancy rates can reach 10–20% per cycle, but by the time someone is over 38, those chances drop significantly. In women aged 40–42, live birth rates per cycle are typically under 10%, and over the age of 43, they are closer to 4% or lower. Beyond 44, live births through IUI are extremely rare. [33]

Because perimenopause often coincides with these ages, IUI is usually only suggested in very specific cases — for example, if ovarian reserve is still reasonable, male factor infertility is mild, and other fertility factors are favourable. Otherwise, IVF or donor egg IVF are usually more effective pathways to pregnancy.

Can I get IVF on the NHS if I’m in perimenopause?

It may be possible to access IVF on the NHS while in perimenopause, but eligibility largely depends on your age and local criteria. [26,34,35]

  • Up to age 40: You may be offered up to three full cycles of IVF.

  • Ages 40–42: You may be offered one full cycle, provided certain conditions are met (such as having a good ovarian reserve and no previous IVF).

  • Over 42: NHS-funded IVF is not usually available.

Because perimenopause often begins in the 40s, this means NHS access is limited. Even if you are within the eligible age range, local integrated care boards (ICBs) set their own rules. Some restrict funding based on BMI, smoking status, or whether you already have children. Waiting times can also be long, so if you’re keen to start quickly, your GP may advise looking at private options.

If you’re in perimenopause and considering IVF, the best step is to speak with your GP. They can confirm whether NHS funding is available in your area, arrange initial tests to assess your ovarian reserve, and discuss referral pathways. If you don’t meet the NHS criteria, private clinics remain an option, though many also have upper age limits (often around 50–52) for treatment.

Is it dangerous to get pregnant during perimenopause?

Pregnancy during perimenopause carries more risks than at younger ages, but that doesn’t mean it’s unsafe in every case. What’s important is to understand the potential complications and make sure you’re well supported by a medical team.

The risks to be aware of include:

  • Higher miscarriage risk: Egg quality declines with age, increasing the chance of early pregnancy loss. [36]

  • Gestational diabetes and hypertension: Both conditions become more common in pregnancies after 40. [37,38]

  • Chromosomal abnormalities: The likelihood of conditions such as Down syndrome rises with maternal age. [39]

With proper medical care, many people in their 40s and even early 50s do go on to have healthy pregnancies. Regular monitoring, specialist support, and early screening can help manage risks and provide reassurance. If you’re considering pregnancy during perimenopause, speaking with a GP, gynaecologist, or fertility doctor before conceiving is an important step.

Summary

Yes, you can get pregnant during perimenopause — but it’s less likely, and it often requires more support. Ovulation can still happen, and natural conception is possible, but fertility treatments like IVF (especially with donor eggs) offer higher chances. With the right care, support, and monitoring, parenthood during perimenopause is still an option.

Perimenopause and fertility FAQs

How can I increase my fertility during perimenopause?

Although fertility naturally declines, you can take steps to support your chances. Eating a balanced diet, staying active, sleeping well, and avoiding smoking or heavy drinking can all help. Stress management is equally important, as high stress can disrupt ovulation. [9]

Some people are advised to take supplements such as folic acid, vitamin D, or CoQ10, though it’s best to check with a doctor first. Tracking ovulation with medical support can also clarify if and when eggs are being released. For many, lifestyle changes may help, but fertility treatments are often the most effective route — something a GP or fertility specialist can guide you through. [8,16,17,18]

What is the oldest age to get pregnant?

Natural pregnancies over 50 are extremely rare, but with donor eggs and IVF, conception into the early 50s can be possible. Most clinics set an upper limit around 50–52, though exceptional cases make headlines — such as a 70-year-old Ugandan woman who gave birth to twins through IVF. These are extraordinary exceptions, and anyone considering pregnancy later in life should seek specialist advice to understand what’s safe and realistic. [40,41,42]

Sources

  1. NHS. Menopause. Page last reviewed: 17 May 2022.
  2. National Institute for Health and Care Excellence. When should I diagnose menopause or perimenopause? Last revised in July 2025.
  3. NHS, Worcestershire Acute Hospitals, NHS Trust. Your journey through the Perimenopause and Menopause. Approval Date 11/08/2023.
  4. Patel MV, Shen Z, Wira CR. Do endometrial immune changes with age prior to menopause compromise fertility in women? Explor Immunol. 2022;2(5):677-692. doi: 10.37349/ei.2022.00076. Epub 2022 Oct 29. PMID: 39931230; PMCID: PMC11809571.
  5. Burger HG, Hale GE, Dennerstein L, Robertson DM. Cycle and hormone changes during perimenopause: the key role of ovarian function. Menopause. 2008 Jul-Aug;15(4 Pt 1):603-12. doi: 10.1097/gme.0b013e318174ea4d. PMID: 18574431.
  6. Delamater L, Santoro N. Management of the Perimenopause. Clin Obstet Gynecol. 2018 Sep;61(3):419-432. doi: 10.1097/GRF.0000000000000389. PMID: 29952797; PMCID: PMC6082400.
  7. Delbaere I, Verbiest S, Tydén T. Knowledge about the impact of age on fertility: a brief review. Ups J Med Sci. 2020 May;125(2):167-174. doi: 10.1080/03009734.2019.1707913. Epub 2020 Jan 22. PMID: 31964217; PMCID: PMC7721003.
  8. Su HW, Yi YC, Wei TY, Chang TC, Cheng CM. Detection of ovulation, a review of currently available methods. Bioeng Transl Med. 2017 May 16;2(3):238-246. doi: 10.1002/btm2.10058. PMID: 29313033; PMCID: PMC5689497.
  9. Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013 Jul 16;11:66. doi: 10.1186/1477-7827-11-66. PMID: 23870423; PMCID: PMC3717046.
  10. NHS, Buckingham Healthcare, NHS Trust. Body weight and fertility. 20/01/2025.
  11. Vigil P, Meléndez J, Soto H, Petkovic G, Bernal YA, Molina S. Chronic Stress and Ovulatory Dysfunction: Implications in Times of COVID-19. Front Glob Womens Health. 2022 May 23;3:866104. doi: 10.3389/fgwh.2022.866104. PMID: 35677754; PMCID: PMC9168655.
  12. Norelli SK, Long A, Krepps JM. Relaxation Techniques. Updated 2023 Aug 28.
  13. Dhage VD, Nagtode N, Kumar D, Bhagat AK. A Narrative Review on the Impact of Smoking on Female Fertility. Cureus. 2024 Apr 16;16(4):e58389. doi: 10.7759/cureus.58389. PMID: 38756292; PMCID: PMC11097250.
  14. Mínguez-Alarcón L, Chavarro JE, Gaskins AJ. Caffeine, alcohol, smoking, and reproductive outcomes among couples undergoing assisted reproductive technology treatments. Fertil Steril. 2018 Sep;110(4):587-592. doi: 10.1016/j.fertnstert.2018.05.026. PMID: 30196942; PMCID: PMC11002791.
  15. Beroukhim G, Esencan E, Seifer DB. Impact of sleep patterns upon female neuroendocrinology and reproductive outcomes: a comprehensive review. Reprod Biol Endocrinol. 2022 Jan 18;20(1):16. doi: 10.1186/s12958-022-00889-3. PMID: 35042515; PMCID: PMC8764829.
  16. Kadir M, Hood RB, Mínguez-Alarcón L, Maldonado-Cárceles AB, Ford JB, Souter I, Chavarro JE, Gaskins AJ; EARTH Study Team. Folate intake and ovarian reserve among women attending a fertility center. Fertil Steril. 2022 Jan;117(1):171-180. doi: 10.1016/j.fertnstert.2021.09.037. Epub 2021 Nov 19. PMID: 34809974; PMCID: PMC8714696.
  17. Dabrowski FA, Grzechocinska B, Wielgos M. The role of vitamin D in reproductive health–a Trojan Horse or the Golden Fleece? Nutrients. 2015 May 29;7(6):4139-53. doi: 10.3390/nu7064139. PMID: 26035242; PMCID: PMC4488777.
  18. Florou P, Anagnostis P, Theocharis P, Chourdakis M, Goulis DG. Does coenzyme Q10 supplementation improve fertility outcomes in women undergoing assisted reproductive technology procedures? A systematic review and meta-analysis of randomized-controlled trials. J Assist Reprod Genet. 2020 Oct;37(10):2377-2387. doi: 10.1007/s10815-020-01906-3. Epub 2020 Aug 7. PMID: 32767206; PMCID: PMC7550497.
  19. NHS. Infertility. Page last reviewed: 09 August 2023.
  20. NHS. Pregnancy, breastfeeding and fertility while taking or using sequential combined hormone replacement therapy (HRT). Page last reviewed: 18 January 2023.
  21. British Fertility Society. At what age does fertility begin to decrease?
  22. Muharam R, Sumapraja K, Pratama G, Azyati M, Prabowo KA. Impact of IVF on the Timing and Symptoms of Menopause. Int J Womens Health. 2021 Sep 22;13:889-893. doi: 10.2147/IJWH.S322718. PMID: 34588821; PMCID: PMC8473711.
  23. Human Fertilisation & Embryology Authority. Fertility treatment 2023: trends and figures. Published: June 2025.
  24. Pantos K, Meimeti-Damianaki T, Vaxevanoglou T, Kapetanakis E. Oocyte donation in menopausal women aged over 40 years. Hum Reprod. 1993 Mar;8(3):488-91. doi: 10.1093/oxfordjournals.humrep.a138077. PMID: 8473473.
  25. Human Fertilisation & Embryology Authority. Using donated eggs, sperm or embryos in treatment.
  26. Human Fertilisation & Embryology Authority. Women over 38. Publication date: 25 April 2025.
  27. Human Fertilisation & Embryology Authority. Donating your eggs.
  28. Human Fertilisation & Embryology Authority. Egg donation: a factsheet.
  29. Human Fertilisation & Embryology Authority. Egg donation: Joanne shares her experience of using an egg donor.
  30. Human Fertilisation & Embryology Authority. Rise of egg and sperm donation ends heartache for thousands, says UK regulator.
  31. Human Fertilisation & Embryology Authority. Intrauterine insemination (IUI).
  32. Haebe, J., Martin, J., Tekepety, F., Tummon, I. and Shepherd, K., 2002. Success of intrauterine insemination in women aged 40–42 years. Fertility and sterility, 78(1), pp.29-33.
  33. Yang S, Peng HY, Li Y, Zhou LY, Yuan L, Ma YM, Wang HC, Li R, Liu P, Qiao J. Intrauterine Insemination Treatment Strategy for Women over 35 Years Old: Based on a Large Sample Multi-center Retrospective Analysis. Chin Med J (Engl). 2016 Dec 5;129(23):2873-2875. doi: 10.4103/0366-6999.194647. PMID: 27901004; PMCID: PMC5146798.
  34. NHS. IVF. Page last reviewed: 15 April 2025.
  35. Seen Fertility. Am I Eligible for IVF on the NHS? Criteria and Eligibility Explained. Updated 07 July 2025.
  36. Owen A, Carlson K, Sparzak PB. Age-Related Fertility Decline. Updated 2024 Feb 2.
  37. Dietl A, Cupisti S, Beckmann MW, Schwab M, Zollner U. Pregnancy and Obstetrical Outcomes in Women Over 40 Years of Age. Geburtshilfe Frauenheilkd. 2015 Aug;75(8):827-832. doi: 10.1055/s-0035-1546109. PMID: 26366002; PMCID: PMC4554509.
  38. NCT. Pregnancy and birth over 35. Last reviewed: 5 November 2024.
  39. NHS England. Down syndrome (trisomy 21). Last reviewed: 30/04/2025.
  40. BBC. Seventy-year-old Ugandan woman gives birth to twins – hospital. Danai Nesta Kupemba. 1 December 2023.
  41. Laufer, N., Simon, A., Samueloff, A., Yaffe, H., Milwidsky, A. and Gielchinsky, Y., 2004. Successful spontaneous pregnancies in women older than 45 years. Fertility and sterility, 81(5), pp.1328-1332.
  42. The Guardian. Births among women over 50 rise 15% in England, figures show. Michael Goodier. Fri 17 Nov 2023.