IVF Over 40: Success Rates, Treatment Options, and What to Expect

There isn’t one “best” IVF protocol for everyone at 40. The right approach depends on your ovarian reserve, previous response to stimulation, medical history, and what you want from treatment (for example, aiming for more embryos in one go, or keeping medication lighter). Treatment should be individualised rather than one-size-fits-all.

Broadly, you’ll hear a few common protocol types:

• Standard antagonist protocols: This is one of the most common approaches in the UK and uses stimulation medication plus a blocker to prevent premature ovulation. It’s often the first-line option at 40 because it aims to collect a solid number of eggs in one cycle. Doses may be higher than earlier in life, but increasing medication only helps to a point. Clinics will usually tailor your starting dose based on AMH, AFC and BMI.
  
  
• Mild, “natural,” or mild IVF protocols: These cycles use lower stimulation doses — or none at all in true natural IVF — and focus more on egg quality than quantity. Clinics like CREATE often recommend them when ovarian reserve is low or when someone prefers a gentler experience. Fewer injections and less monitoring can feel easier on the body. The trade-off is typically fewer eggs per round, which may mean more cycles overall.
  
  
• When higher stimulation might be used: Some people in their early 40s may benefit from slightly higher doses to recruit as many follicles as the ovaries can offer. This works best if your AMH and AFC suggest you still have a reasonable cohort to respond. Very high doses, however, have limits and won’t force the ovaries to produce extra eggs. Evidence consistently shows that matching dose to your actual reserve is far more effective than maximising medication.

Ultimately, personalisation matters more than the label of your protocol. A good clinic will assess your response to each cycle and adjust the plan, dose or trigger to refine outcomes. For some, that might mean shifting to a milder cycle; for others, it may mean fine-tuning stimulation to improve response. What truly drives results is ongoing individualisation, not the protocol category itself.

Cheap IVF for over 40: is it possible?

Talking about money alongside age can feel uncomfortable, but it’s a practical part of planning IVF in your 40s. Some clinics in the UK offer lower-cost pathways by streamlining treatment or using more standardised, nurse-led protocols — helpful for keeping budgets manageable as long as you feel confident in the level of support. Mild IVF can also reduce medication and monitoring costs, though you may need more cycles overall, so it’s worth asking for the total likely cost rather than focusing on one round.

Shared-risk or refund programmes, often available in the UK and abroad, can offer financial predictability, but they require careful reading of eligibility rules and refund conditions. IVF overseas — in countries like Spain, Greece or the Czech Republic — can be more affordable too, particularly for donor-egg cycles, although regulations, success rates and support vary, so independent verification is essential. And wherever you look, stay cautious of clinics that guarantee pregnancy, lean heavily on costly add-ons, or avoid explaining how they calculate success rates.

Affordable IVF is possible, but value and transparency should take priority over the lowest price tag. The right clinic will be upfront about costs, realistic about outcomes and clear about the care you’ll receive.

Add-ons often offered after 40: What does the evidence say?

If you’re over 40, you’re more likely to have add-ons suggested — extra treatments on top of standard IVF, such as:

• Growth hormone: Some clinics offer growth hormone to support egg development in people with a low ovarian response, but current evidence shows mixed and inconsistent results, with no clear improvement in live birth rates. It remains an experimental option rather than a proven intervention. [14]
  
  
• DHEA or testosterone “priming”: DHEA and testosterone are sometimes used to support follicle growth before stimulation, and a few studies suggest they may help people with very low ovarian reserve. That said, the research is limited and results vary, so these supplements should only be used under clinical guidance. [15,16]
  
  
• Ubiquinol (CoQ10): CoQ10 is an antioxidant thought to support mitochondrial function in eggs, and early studies suggest it may improve some markers of egg quality. While it’s widely used, high-quality evidence in humans is still emerging, so expectations should be realistic. [17]
  
  
• Double stimulation / “duostim” in the same cycle: Duostim involves completing two stimulation rounds in the same menstrual cycle to maximise egg collection for those with low ovarian reserve. It can increase the total number of eggs retrieved in a shorter time frame, but it doesn’t change egg quality and isn’t needed for everyone. [18]
  
  
• Immune tests: Immune testing is frequently marketed to people with repeated IVF failure, but the HFEA states that there is no strong evidence linking most immune markers to fertility outcomes. These tests can be costly, and recommended treatments often lack reliable proof of improving live birth rates. [19]

The HFEA is clear that many IVF add-ons have limited or uncertain evidence for improving live birth rates, and they use a traffic-light system to help patients see this at a glance. Growth hormone, DHEA and immune therapies in particular often sit in the “more research needed” category rather than “clearly beneficial.” [20]

That doesn’t mean no one ever benefits; it means we don’t yet have strong, consistent data to say they reliably improve outcomes. Before agreeing to any add-on, ask:

• What is the specific problem this is meant to address in my case?
  
  
• What does the evidence say about live birth rates, not just lab outcomes?
  
  
• How much does it cost, and is it essential or optional?

Your age may be part of the discussion, but it shouldn’t be the only reason something is suggested.

Should I use donor eggs after 40?

This is one of the biggest questions for many people in their 40s, and it deserves space that’s calm, clear and free from judgement. Donor eggs can transform the outlook because embryos from younger donors are less affected by age-related chromosomal changes, and the HFEA shows that success rates stay relatively steady across recipient ages. That’s why clinics often start discussing donor eggs from around 43 onwards — not to limit your options, but to give you transparent numbers so you can decide whether to keep trying with your own eggs or explore a donor route. [9]

There are also common misconceptions to untangle. Many worry the baby won’t feel “theirs,” but carrying the pregnancy and becoming the parent shapes that bond far more than genetics alone. Donor-egg IVF is already a major path to parenthood for people in their 40s and 50s, with strong outcomes when donors are carefully screened and embryos are created in high-quality labs.

You can pursue donor eggs in the UK, where donors are identifiable to the child at 18, or abroad in countries like Spain, Greece or the Czech Republic, where donors are typically anonymous and waiting times can be shorter. Costs vary — donor-egg cycles are usually more expensive but often require fewer attempts — so it’s worth asking for a clear breakdown of timelines and fees wherever you choose to explore treatment.

Choosing donor eggs isn’t a last resort; it’s a valid and proactive path. The right moment to consider it is when the numbers, your emotional bandwidth and your long-term goals point you in that direction.