Fertility treatments for women over 40
Age 40 is the critical threshold where the right approach can provide a >30% success boost and superior cost efficiency, depending on the path you select. At Avenues, we look at your whole fertility picture, not just your age. During your consultation, our doctors will review your complete medical history and fertility assessment results to create a personalised plan tailored to your needs.
Fertility treatment after 40 is not one-size-fits-all. We shape it by your specific biology, goals, and values.
Traditional success metrics per embryo transfer or collection can be misleading for patients of advanced maternal age.
The Avenues Solution: We focus on the “Cost to Baby” and “Time to Baby”, minimising stress and maximising your chances of a successful pregnancy through batched cycles and genetic testing.
Every 40+ journey is different. Each route below shows its live birth rate up front per journey, then your consultant tailors the plan to your biology.
36% live birth rate
Patients over 40 with a higher AMH and robust antral follicle count.
Genetic screening means only healthy embryos are transferred, sparing the toll of failed transfers and miscarriage.
Lowest chance of success on a per cycle basis.
55% live birth rate
Our flagship pathway, built for advanced maternal age or low ovarian reserve.
Three cycles of egg stimulation and collection, then a single batch fertilisation with PGT-A testing. Triples the eggs available to find a euploid embryo, cutting the no-embryo-to-transfer risk from ~50% to 16%. Reach pregnancy in ~6 months on average, versus 18 months for traditional single cycles.
56% live birth rate
When own-egg success rates are very low, or after previous failures.
A programme of 6 donor eggs with AI-powered matching, plus specialist counselling and a dedicated team. Highest chance of success, with a no-embryo risk of just 7% and miscarriage risk down from 73% to 37%.
Live birth rate per patient, age 40+ (Avenues data, 2024–25; n=65 from 57 patients). HFEA groups 40+ with 38+ and reports a 22% cumulative average. Full methodology →
Per-cycle price can mislead. We focus on cost to baby and time to pregnancy and what actually gets you home with a child.
| IVF + ICSI | Impact IVF | Donor Eggs | |
|---|---|---|---|
| Chance all embryos aneuploidLower is better | 47% | 5% | 7% |
| Cost per treatmentLower is better | £9,979 | £18,949 | £14,390 |
| Cost to babyMetric that matters | £58,977 | £34,452 | £25,696 |
| Time to pregnancyMetric that matters | 18 mo | 4 mo | 1 mo |
1. The HFEA currently reports clinic performance using live birth rate per embryo transferred or per egg collection. These KPIs don’t fully reflect clinic competency or the patient journey. A more meaningful, patient-centred metric is live birth rate per patient, capturing overall likelihood of success across an entire treatment pathway rather than a single cycle. Since HFEA reporting is delayed, the data here hasn’t yet been submitted or published by HFEA — though HFEA have confirmed (unpublished) that Avenues’ data is consistent with the national average. The clinic’s focus is on reducing cost to baby, time to baby, and improving convenience for every patient. Avenues doesn’t restrict transfers to only expanded day 5–6 embryos; every blastocyst is given a chance, including earlier-stage ones on day 7. Clinical decisions are made in each patient’s best interest, not to optimise headline stats — patients should be aware some clinics don’t culture embryos to day 7 or only biopsy expanded, high-quality blastocysts, and while this may improve reported metrics, it can reduce overall cumulative success across a full treatment journey.
2. HFEA doesn’t report outcomes specifically for patients over 40; instead they’re grouped with patients over 38.
3. For patients over 38, the cumulative live birth rate is 22% (Avenues data shows 36% for patients over 40, n=65 cycles from 57 patients) — exceeding the national average despite including only patients over 40.
4. On a per-embryo-transferred basis, HFEA reports a 16% national average for patients over 38; Avenues’ outcomes for patients over 40 exceed national averages reported for patients under 38.
5. Avenues doesn’t consider per-embryo metrics sufficient to assess true clinic competency and instead recommends per-patient metrics.
6. “Other centres” is defined as meeting Vienna Consensus competency values, though not all centres achieve these standards.
7. All data reported reflects Vienna Consensus competency values.
8. All data reported in this booklet reflects 2024–2025 cycles, the most recent live birth outcomes available. All cycles are included except OVOM and Lisa Stradiotto patients, as these no longer form part of Avenues. The multiple birth rate for this period was 0.7%, demonstrating effective embryo assessment and responsible transfer practices.
9. Leading London Clinic refers to HFEA Ranking as of 05/05/2026, excluding clinics with fewer than 100 cycles, per HFEA’s Choose a Fertility Clinic tool.
A free discovery call is the fastest way to understand your options with no obligation.
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 it 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:
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.
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:
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.
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