- Your ovarian reserve (egg count) can be estimated with AMH and FSH blood tests.
- Start taking at least 400mcg of folic acid daily before you begin trying.
- Focus on a healthy BMI, a balanced diet, and reducing alcohol and smoking.
- Most women over 35 in the UK have healthy pregnancies with the right care.
Understanding Your Ovarian Reserve
As you get older, the number and quality of your eggs naturally decline. This is what we call ovarian reserve. For women in the UK considering pregnancy after 35, it can be helpful to get a baseline understanding of where you stand.
We primarily assess this with blood tests that measure Anti-Müllerian Hormone (AMH), which is produced by developing egg sacs, and Follicle-Stimulating Hormone (FSH). A higher AMH and lower FSH level are generally favourable, but these numbers are just part of a much bigger picture and not a definite predictor of your fertility.
Essential Supplements and Nutrition
Before you even start trying to conceive, there are simple steps you can take to prepare your body. The most critical is taking a daily folic acid supplement. The standard advice is 400 micrograms to significantly reduce the risk of neural tube defects like spina bifida.
Beyond that, it's wise to ensure your Vitamin D levels are adequate, as many people in the UK are deficient. A balanced diet rich in whole foods, lean proteins, and leafy greens provides the other essential nutrients your body needs to gear up for a healthy pregnancy.
Lifestyle Factors Within Your Control
While we can't turn back the clock, we can control key lifestyle factors. Maintaining a healthy weight is crucial, as being either underweight or overweight can disrupt your menstrual cycle and affect ovulation. Sensible, regular exercise can help manage weight and reduce stress.
It is also vital to stop smoking and limit your alcohol intake as both are known to harm fertility and the health of a future baby. Reducing caffeine to one or two cups of coffee a day is a sensible precaution. These adjustments are things the NHS consistently recommends for all women trying to conceive, regardless of age.
Frequently asked questions
Is it still possible to have a healthy pregnancy after 35?
Yes, absolutely. While fertility does decline with age, many women in their late 30s and early 40s conceive naturally and have healthy pregnancies. The key is to understand your personal health profile and optimise it before you start trying.
What are the most important fertility tests to have?
A simple blood test can check your Anti-Müllerian Hormone (AMH) and Follicle-Stimulating Hormone (FSH) levels. These give us a snapshot of your ovarian reserve, which can be helpful for planning. However, they don't predict your exact chances of conception month by month.
How much folic acid should I really be taking?
At least 400 micrograms (mcg) of folic acid is recommended daily for at least one month before you start trying to conceive, and for the first 12 weeks of pregnancy. This helps prevent neural tube defects. Some women may need a higher dose, which I can advise on.
Beyond folic acid, what are the most important lifestyle changes?
The main focus is on a balanced diet, regular moderate exercise, maintaining a healthy weight, stopping smoking, and reducing alcohol and caffeine intake. These lifestyle factors can have a significant impact on egg quality and your overall health during pregnancy.
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