Having Children Later in Life: The Real Price of Time

Having children later in life often means greater professional and relationship stability. It can also make conception slower and increase medical costs. Age affects women and men in different ways. This article separates those effects, with concrete figures on fertility, pregnancy and the child’s health. You will also find the cost of IVF, egg freezing and embryo testing. The aim is simple: to help you discuss your family timeline without dismissing the risks or giving in to fear.

How a woman’s age changes fertility

A woman’s fertility declines with age. The decline is gradual during her thirties, then accelerates after 35. It does not mean that pregnancy becomes impossible.

Two changes occur. The number of eggs falls. The remaining eggs are also more likely to have an abnormal number of chromosomes. Regular periods provide no certain information about either point.

For a healthy woman, the American College of Obstetricians and Gynecologists gives these estimates:

• Before 30: around 20 to 25 pregnancies per 100 cycles of trying.
• At 35: around 15 pregnancies per 100 cycles.
• At 40: around 5 pregnancies per 100 cycles.

These figures are averages. Both partners’ health and the man’s fertility affect a couple’s chances.

What IVF can change

IVF does not make eggs younger. Once an embryo has been created, the doctor can place it in the uterus. This step is called an embryo transfer.

The UK fertility regulator, the HFEA, counted births following this step in 2023. The women used their own eggs.

Source: HFEA, treatments in 2023. One transfer means one embryo placed in the uterus. The table excludes women whose treatment stopped before this stage.

Before a transfer, eggs must be collected and fertilised, and at least one embryo must develop. Treatment can stop at any of these stages. This risk rises with the woman’s age when her eggs are collected.

With donor eggs, the donor’s age determines this part of the process. The pregnant woman’s own age still affects the risks during pregnancy.

Risks for the pregnancy and the child

In 2019, a Norwegian study published in The BMJ followed 421,201 pregnancies. Miscarriage increased with the mother’s age. Between 35 and 39, most pregnancies did not end in miscarriage. The risk became much higher in a woman’s forties.

Geneva University Hospitals also provide figures for Down syndrome. These figures do not describe effects associated with the father’s age.

Sources: Magnus et al., The BMJ, 2019; Geneva University Hospitals. At 40, around 99 births in 100 therefore occur without Down syndrome.

A pregnant woman’s age also increases the frequency of gestational diabetes, high blood pressure and pre-eclampsia. Pre-eclampsia is a complication involving high blood pressure. Weight, smoking, multiple pregnancies and medical history also play a role. After 35, these figures justify appropriate medical monitoring.

Key takeaway: a woman’s age affects her eggs and the course of pregnancy. A man’s age affects other aspects.

How a man’s age changes fertility

A man can produce sperm late in life. This does not mean that his age has no effect.

In 2024, joint guidance from ACOG and the AUA associated paternal age with three developments:

• changes in some sperm characteristics;
• a potentially longer time to conception;
• more miscarriages and stillbirths.

The number of new mutations transmitted through sperm also increases with age. Researchers also observe higher rates of certain neurodevelopmental conditions, including autism and schizophrenia.

These studies show statistical associations. They cannot predict an individual child’s health. Family history, the mother’s age and environmental factors also matter. For a rare condition, even a large proportional increase in risk can still affect very few births.

Both ages matter

A younger partner improves the chances associated with eggs. She does not remove the effects associated with the father’s age. A younger father does not remove the risks associated with the pregnant woman’s age.

For a 50-year-old man, choosing a younger partner does not reset his own age. Embryo chromosome testing does not correct new mutations associated with paternal age either. If in doubt, a doctor can assess both partners.

How much do IVF and other treatments cost?

Many couples conceive naturally after 35. They pay for no fertility treatment. For others, the price depends on the country, insurance coverage and the number of attempts.

In France, national health insurance covers fertility treatment under certain conditions. Eggs can be collected until a woman’s 43rd birthday. Some costs may remain, including extra medical fees and travel.

Sources: French national health insurance for coverage in France; public clinic prices for ranges; Herasight for its launch price. Only a current quotation shows the real cost.

These prices do not always add up. Here are three examples.

1. A 37-year-old woman conceives naturally. There may be no extra cost beyond pregnancy monitoring. Nobody knows in advance how long conception will take. The man’s fertility also matters.
2. A woman has two IVF cycles at 40. Without coverage in France, two cycles cost around €5,000–12,000 before additional expenses. This spending does not guarantee a birth.
3. A woman over 43 needs donor eggs. A younger donor’s eggs change the chances of conception. The couple must also accept donation and its family implications. In France, the average wait was 22 months in 2025, according to the Agence de la biomédecine. Abroad, treatment costs and local rules must be checked.

Egg freezing and embryo testing

Egg freezing allows eggs to be used later. It does not guarantee a birth.

In a Guy’s Hospital study published in 2023, 74 eggs out of 100 survived thawing. Among the surviving eggs, 67 out of 100 were then fertilised. In this study, 27 women returned to use their eggs. For 7 of them, no embryo could be placed in the uterus.

These results need careful interpretation. Across the ten studies reviewed by the authors, only 12 women in 100 had returned to use their eggs at follow-up.

Age at egg collection remains crucial. A model cited in this study estimated the number of eggs needed to aim for a 75% probability of a live birth:

• around 10 eggs at 34;
• around 20 eggs at 37;
• around 61 eggs at 42.

These are theoretical estimates. They are not a promise of results. One egg collection may not be enough.

What do embryo tests do?

PGT-A examines an embryo’s chromosome count. It can rule out some embryos with an abnormal count. It does not repair these embryos or create new ones. In 2024, the ASRM concluded that the value of this test for all patients had not been demonstrated. It does not detect new mutations associated with paternal age.

PGT-M looks for a specific disease caused by one gene and already known in the family. Cystic fibrosis is one example.

PGT-P attempts to estimate risks involving many genes. These may include diabetes, some heart diseases and some psychiatric conditions. Some companies also offer estimates for height or intelligence. In 2026, the ASRM concluded that this test should not yet be offered to patients.

Herasight offers this type of estimate. The company displayed a $50,000 launch price. This included genetic analysis and support, but not IVF.

A score calculated from adult data does not prove that a selected embryo will become a healthier adult. When a couple has only a few embryos, the differences between their scores can also be very small. The test provides additional information. Its real usefulness remains uncertain.

Key takeaway: no test can create an embryo. Genetic predictions over an entire lifetime still carry major uncertainties.

Children earlier or later: differences in daily life

Older parents have often completed their education longer ago. Their income and housing are generally more stable. These resources can benefit the child.

A US study published in Demography in 2018 observed small educational and behavioural gains among children when a first birth was postponed by one year. The mother’s education explained much of this result. This average does not mean that a child born to a 40-year-old mother will do better than one born to a 30-year-old mother.

Becoming a parent young can complicate education or the start of a career. It can also lead some people to start a family before they have enough perspective on their relationship.

Becoming a parent later leaves less time for another pregnancy. Professional responsibilities may be demanding. Some parents must also support their own ageing parents while raising young children. These constraints cannot be measured in money alone.

Choosing a partner and choosing a timeline are two different questions. Do not rush a relationship to have a child quickly. Do not wait for years assuming that medicine will solve every difficulty either.

What I observe in couples’ plans

Since 2022, I have seen men choose a partner carefully and then postpone the conversation about children. Yet three subjects should be discussed early: the desired number of children, the timeline and the possible use of medical assistance.

At my agency, I introduce women whom my team has met through video calls, with an interpreter when needed. Discussions are clearer when each person explains their plans concretely. A man can say whether he wants one child or three, and whether he feels ready in one year or five. The woman can do the same and explain her own limits.

Talking early avoids two mistakes: rushing into a relationship or letting years pass without discussing the future. The age gap in a shared life plan matters. Honesty about commitment and the ability to build a strong relationship are equally important.

Key takeaway: discuss the number of children and the timeline before committing to a relationship that may last for years.

Frequently asked questions

At what age is a pregnancy considered late?

Doctors often use 35, the pregnant woman’s age, as a threshold for adapting monitoring. Fertility does not change abruptly on that birthday. Its decline is gradual and generally becomes more pronounced after 35, then after 40. This threshold applies to women. It does not define advanced age in men.

Should both partners have a fertility assessment?

An assessment is not compulsory for everyone. It can be useful if you plan to wait, have a relevant medical history or have been trying to conceive for some time.

For a woman, a blood test and an ultrasound estimate the number of remaining eggs. They cannot predict the chances of natural conception on their own. For a man, a semen analysis examines the sperm. It does not measure every possible effect of paternal age.

Does egg freezing guarantee a child later?

No. It creates an additional option, especially when eggs are collected young and in sufficient numbers. Losses can occur during thawing, fertilisation, embryo development and pregnancy.

Ask the clinic how many births it has achieved by the woman’s age at collection and the number of eggs used. The survival rate after thawing alone is not enough.

Does PGT-A guarantee a healthy baby?

No. This test mainly examines the chromosome count in a few cells from the embryo. It does not detect every disease. It does not guarantee that pregnancy will begin or that a baby will be born. The result is sometimes uncertain. Its usefulness depends on the couple’s situation and should be discussed with the medical team.

Does a younger partner compensate for the father’s age?

No. Her younger eggs can improve the chances of conception and reduce chromosome risks associated with her own age. They do not remove risks associated with the father’s age or either family’s medical history.

What budget should I plan for IVF?

Request a detailed quotation. It should separate consultations, medication, egg collection, laboratory work, freezing, embryo transfer and anaesthesia. Add travel and the possible cost of another cycle. The price of one cycle is not the total cost of a birth.

How can you decide without giving in to fear?

Having children later can give a couple greater stability. It can also lengthen the process and increase medical costs. A woman’s age and a man’s age have different effects. Both must be taken into account.

The discussion should cover three concrete points: how many children you want, when you feel ready and which medical options you would accept. To check whether your plans match those of the women you would like to meet, take the compatibility test.