Your 40+ Journey to Parenthood

Not necessarily, but time does matter.

Some women in their 40s are still able to conceive with their own eggs, but the window is narrower, and outcomes are less predictable. The most important step is understanding your current fertility profile, so you’re not losing time on the wrong approach. That’s why at Avenues, treatment is built around your specific biology –  your ovarian reserve, your hormone levels, your embryo quality –  not your age as a number.

As women age, eggs are at significantly increased risk of chromosomal abnormalities, leading to a higher rate of genetically unbalanced embryos.
Most failed cycles and miscarriages over 40 come down to transferring an embryo that was never viable. That’s exactly what PGT-A genetic screening addresses: identifying chromosomally normal embryos before transfer, so you’re not spending time and emotional energy on cycles that can’t succeed.

Regular periods are reassuring. But they tell you nothing about the quality of the egg being released.

After 40, it’s entirely possible to have a textbook cycle every month and still the eggs might be chromosomally unlikely to result in a pregnancy: if isn’t genetically destined to implant, it won’t. And the only place egg quality can truly be evaluated is in the lab — once the eggs are retrieved and assessed directly.

Our Egg Intelligence™ provides at least 22% better prediction of egg viability than human assessment alone — going beyond what any scan or blood test can reveal. And for patients over 40, where low ovarian reserve is the norm rather than the exception, that level of precision isn’t a luxury.

After 40, the most common reason is chromosomal abnormalities in the embryo.

Even when implantation happens, many pregnancies cannot progress because the embryo isn’t genetically viable. This is why miscarriage rates increase with age—and why embryo screening or donor eggs can significantly change outcomes.

This can feel like repeated disappointment with no clear explanation.
In reality, it’s often a numbers and biology problem: as egg quantity decreases with age, so does the proportion of those eggs that will produce a chromosomally healthy embryo.
It might lead to a situation, when the embryo that was transferred was never viable to begin with — and without genetic screening, there’s no way to know that until it’s too late.

At Avenues, we look at this differently. Our Embryo Intelligence™, trained on data from millions of embryos, identifies which embryos have a genuine chance of implanting before any transfer happens. And rather than working with what a single cycle produces, Impact IVF consolidates three cycles to give us a large enough pool to find the ones worth transferring.

Your AMH level tells you about quantity: specifically, how many eggs your ovaries are likely to produce in a stimulated cycle. It helps your clinical team choose the right protocol — whether to stimulate aggressively or take a gentler approach to avoid overwhelming eggs that respond better to a milder regime. 

There are also associations between lower AMH and lower egg quality, which can affect your ability to conceive each month. But AMH alone doesn’t determine your outcome. The normal range for AMH is extremely wide — there is no single level that is right or wrong, and a low result is not a ceiling on what’s possible.

At Avenues, AMH is one input into a much broader assessment. The Reproductive Intelligence Review™ looks at the full picture: eggs, sperm, uterus, hormones, and lifestyle, together. Because optimising for a family means understanding what your numbers mean for you specifically, not what they mean on a reference range.

Failed cycles are data. They tell you something about your eggs, your embryos, your uterine environment — if someone is willing to look closely enough.

What usually needs to change is the strategy:

• Build a larger embryo pool. One cycle rarely gives you enough to work with after 40. Our Impact IVF consolidates three cycles to maximise the number of eggs available, giving AI-powered assessment more to find the viable ones from.
• Stop transferring blindly. If previous transfers failed without genetic screening, you may have been transferring embryos that were never chromosomally viable. PGT-A identifies the embryos with a genuine chance of implanting before any transfer happens.
• Look at the sperm differently. Semen Intelligence™ analyses sperm at a level traditional methods don’t reach — uncovering hidden biomarkers of infertility that a standard semen analysis would miss entirely.

A fresh plan should be built on what your previous cycles have already revealed — not despite them.

There’s no universal number—but there should always be a clear rationale.

If each cycle is giving new information or improving your chances, continuing may make sense. If not, it’s important to reassess rather than continue out of momentum.

A good clinic will help you understand when persistence is still productive—and when it may be time to consider a different path.

If you’re repeating cycles without a change in approach, that’s usually a sign.

Time matters more after 40, so each cycle should have a clear purpose: either to improve your chances or to help you make a more informed next decision. If neither is happening, it’s worth pausing and re-evaluating.

PGT-A screens embryos for chromosomal abnormalities before transfer. It doesn’t change the outcome of an embryo or improve its quality, but it can help you make informed decisions and may shorten the time needed to achieve a successful pregnancy — particularly important after 40 when time is a real factor. At Avenues, it forms part of the Impact IVF pathway for patients with advanced maternal age or low ovarian reserve.

Impact IVF is a comprehensive treatment journey that combines three egg retrievals into one seamless plan. It’s designed to maximise your egg yield, improve embryo quality with AI support, and reduce both emotional and financial strain compared to doing three separate IVF cycles.

Yes. You can add genetic testing (PGT-A) for 3 embryos, plus a frozen embryo transfer (FET), for an additional £2,000 when bundled with Impact IVF.

Usually, when multiple cycles haven’t produced a viable embryo, or when testing shows a very low likelihood of success with your own eggs.

For many women, this isn’t about giving up, it’s about choosing the path with the highest chance of success in the time they have.

Usually, when multiple cycles haven’t produced a viable embryo, or when testing shows a very low likelihood of success with your own eggs.

For many women, this isn’t about giving up, it’s about choosing the path with the highest chance of success in the time they have.

During ICSI, our AI system deeply analyses sperm in real time to choose the one most likely to fertilise an egg successfully. It looks at far more than just shape and movement, uncovering subtle patterns that manual techniques often miss. This leads to higher fertilisation rates and stronger embryos.

Our Embryo Intelligence platform tracks embryo development with time-lapse imaging and compares it to data from millions of previous cases. It predicts which embryos are most likely to implant, helping us select the best one for transfer and reducing the chance of miscarriage or failed cycles. rates and stronger embryos.

Our treatment packages include the medications required for a standard treatment protocol. The cost of these medications is included within your package price up to the applicable Package Medication Allowance. 

Every patient’s treatment is personalised, with the exception of Fair IVF. If your Consultant determines that your treatment requires additional medications, higher medication dosages, or a longer course of medication than is included within your package, these medications are not included in your package price and will be charged separately. 

Examples of medications or treatments that may incur additional charges include, but are not limited to: 

• Human Growth Hormone (HGH)  

• Pergoveris® above 150 IU per day  

• Stimulation medication above 300 IU per day  

• Stimulation medication required beyond 10 days  

• Lubion® more than once daily  

• Clexane® / Inhixa®  

• Prednisolone  

• Melatonin  

• Immunology medications  

• Any medication outside the standard treatment protocol prescribed by your Consultant  

If additional medication is clinically required, your Consultant will explain the medical reason for the recommendation. Before any additional medication is dispensed or treatment proceeds, your Patient Navigator will explain the associated costs and obtain your agreement. 

Where possible, you will always be informed of any additional medication charges before these costs are incurred.