Female Infertility
Ovarian Ageing
Ovarian ageing is the natural decline in a woman's egg supply and quality over time. It is one of the most significant factors affecting female fertility, but with early assessment and the right treatment, many women can still achieve a successful pregnancy.
When to Seek Fertility Advice
- • Age 35 or above and trying to conceive
- • Low AMH or reduced antral follicle count
- • Irregular or shortening menstrual cycles
- • Family history of early menopause
What is Ovarian Ageing?
Every woman is born with a fixed number of eggs. As she ages, both the quantity and quality of these eggs gradually decline — a process known as ovarian ageing. This affects not only the ability to conceive naturally but also the success of fertility treatments. In some women, this decline happens earlier than expected, a condition called diminished ovarian reserve or premature ovarian ageing.
Common Symptoms
- Irregular or missed periods
- Difficulty conceiving naturally
- Shorter menstrual cycles
- Low AMH levels on blood test
- Reduced antral follicle count on ultrasound
- Early onset of perimenopause symptoms
Causes of Ovarian Ageing
While biological ageing is the primary driver, several other factors can accelerate the decline in ovarian reserve. Understanding these causes helps in planning the most effective fertility strategy.
Natural biological ageing of the ovaries
Diminished ovarian reserve (low egg count)
Genetic factors and family history of early menopause
Previous ovarian surgery or cyst removal
Chemotherapy or radiation therapy
Autoimmune conditions affecting ovarian function
Endometriosis damaging ovarian tissue
Lifestyle factors such as smoking and chronic stress
Diagnosis
Ovarian reserve is assessed through an AMH (anti-Müllerian hormone) blood test and a transvaginal ultrasound to count antral follicles (AFC). These tests, combined with FSH and oestradiol levels, give a comprehensive picture of remaining egg supply and help guide personalised treatment planning.
How It Affects Fertility
As ovarian reserve declines, fewer eggs are available each cycle, and the eggs that remain are more likely to have chromosomal abnormalities. This reduces the chances of natural conception, increases the risk of miscarriage, and can lower the response to fertility stimulation drugs used in IVF.
Treatment Options
Treatment is tailored to each woman's ovarian reserve, age, and fertility goals. Our specialists design a personalised plan to maximise the chances of conception using the most suitable approach.
Ovarian Reserve Testing
AMH blood tests and antral follicle count scans help assess the remaining egg supply and guide the most appropriate fertility treatment pathway.
Lifestyle & Nutritional Support
Targeted antioxidants, CoQ10 supplementation, a balanced diet, and avoiding smoking may help support egg quality even when reserve is declining.
Ovarian Stimulation & IVF
Customised stimulation protocols can maximise egg retrieval in women with diminished ovarian reserve, improving the chances of obtaining viable embryos.
Egg Freezing (Fertility Preservation)
For women not yet ready to conceive, freezing eggs at a younger age preserves their quality before further decline occurs.
Donor Egg IVF
When ovarian reserve is severely depleted, using eggs from a young, healthy donor with the partner's or donor sperm offers high success rates.
Embryo Genetic Testing (PGT-A)
Preimplantation genetic testing helps select chromosomally normal embryos, which is especially important when egg quality may be affected by age.