Getting pregnant at 40: chances and costs in Germany, Austria, and Switzerland

This page covers Germany, Austria, and Switzerland.

Between ages 35 and 45, the numbers around getting pregnant change noticeably from one year to the next. The chance per cycle falls, and the risk of miscarriage rises. In Germany and Austria, the health insurance contribution to IVF and ICSI also ends at the 40th birthday, with a few exceptions.

Here you will find the key figures for every year of age from 35 to 45, each with its source and the group that was counted. Many figures online come from old brochures without a primary source or mix up definitions. That is why every figure states what it refers to.

All values are averages for the groups studied, and from age 40 some of those groups include only a few dozen women. They do not predict how things will turn out for you, and they are not a substitute for medical advice.

All ages at a glance

The table summarizes four key figures for each year of age. The columns come from different studies of different groups. What was counted in each case is explained in the notes below the jump links.

Sources: Steiner and Jukic 2016 (natural chance), Magnus et al. 2019 (miscarriage), German IVF Registry (Deutsches IVF-Register, D.I.R.), 2024 yearbook, fresh cycles 2019 to 2023, our own calculation from pp. 26 and 27 (live birth per transfer), Franasiak et al. 2014 (embryos). The miscarriage shares after IVF and ICSI in the text are also our own calculations: a weighted average from the IVF and ICSI tables, based on clinical pregnancies. For ages 35 to 39, the individual years were read from a chart in the registry; the group value is 24.3%. The registry does not record early biochemical losses.

Jump straight to your age:

• Getting pregnant at 35
• Getting pregnant at 36
• Getting pregnant at 37
• Getting pregnant at 38
• Getting pregnant at 39
• Getting pregnant at 40
• Getting pregnant at 41
• Getting pregnant at 42
• Getting pregnant at 43
• Getting pregnant at 44
• Getting pregnant at 45

How to read the table:

• Natural chance: US cohort of 960 women aged 30 to 44 with no known infertility. A positive pregnancy test was counted, so this includes pregnancies that end early. The study reports only age groups, with small groups from age 40 (37 and 14 women). For ages 42 to 44, the 95% confidence interval after 12 cycles ranges from 24% to 80%. For age 45, there are no data.
• Miscarriage: all pregnancies recorded in Norwegian health registries from 2009 to 2013 (421,201), with miscarriages from the 6th up to before the 20th week of pregnancy. Very early losses without contact with specialist care are missing, and the values are adjusted for pregnancy terminations. The individual years were read from a chart in the study, hence “about.” For age 45, the table shows the value for the group aged 45 and older.
• Live birth per embryo transfer: only women in fertility treatment using their own eggs, with IVF and ICSI combined. The denominator is the transfer, not the started treatment. Depending on age, from 2019 to 2023 about 20% (ages 35 to 39) to 28% (age 45 and older) of egg retrievals did not lead to a transfer (our own calculation from pp. 26 and 27). The row for 45 applies to all women aged 45 and older.
• Chromosomally abnormal embryos: 15,169 biopsies of blastocyst-stage embryos from one US center, so only from women whose embryos developed that far. For age 45, the study’s own table is internally contradictory.
• The columns come from different countries and years and cannot be combined with one another.

Getting pregnant at 35

In the US cohort of Steiner and Jukic, the average chance per cycle at ages 34 to 35 was 16.2%. After 12 cycles, 82% of the women had a positive pregnancy test. Leridon’s calculation model counts only conceptions that lead to a birth, and for a start at age 35 it arrives at 66% in the first year.

In Norway, about 13% of recognized pregnancies at age 35 ended in miscarriage.

After IVF or ICSI using the woman’s own eggs, 35.5% of embryo transfers led to a clinical pregnancy and 26.9% to a live birth, according to the German IVF Registry. About 19% of these pregnancies ended in miscarriage (read from a chart in the registry).

From age 35, professional societies recommend a workup if it has not worked after 6 months. If you are not yet planning to have a baby, elective egg freezing may be relevant. Goldman’s 2017 calculation model puts the need at about 12 mature eggs up to age 35 for a 75% chance of at least one live birth. The authors themselves consider their values possibly too optimistic.

In Germany, the statutory health insurance fund pays 50% of up to three IVF or ICSI attempts for married couples. In Austria, the IVF Fund (IVF-Fonds) pays 70%, with the second tariff tier applying from age 35. Swiss mandatory basic health insurance (Grundversicherung) does not pay for IVF, but it pays for up to three inseminations per pregnancy.

Getting pregnant at 36

The cohort of Steiner and Jukic combines ages 36 and 37: a 14.5% chance per cycle and 76% positive tests after 12 cycles. Per cycle, that is about one fifth lower than for women aged 30 to 31. In a second cohort from North America (Wesselink 2017), 74.8% of women aged 34 to 36 became pregnant within 12 cycles.

The risk of miscarriage in Norway at age 36 was about 15%.

According to the German IVF Registry, at age 36 after IVF or ICSI, 33.1% of transfers led to a clinical pregnancy and 24.7% to a live birth. About 21% of the pregnancies ended in miscarriage.

A workup always involves both partners, and a semen analysis is part of it. For elective egg freezing, the Goldman model puts the need at about 16 mature eggs at age 36 for a 75% chance. From age 36, it assumes that 85% of eggs survive thawing, compared with 95% for younger women.

Switzerland has no fixed age limit for treatment. However, a couple must be expected to be able to care for the child until the child comes of age.

Getting pregnant at 37

The same cohort values apply at 37 as at 36: 14.5% per cycle and 76% after 12 cycles. After 6 cycles, 69% in this age group had a positive test.

In Norway, about 17% of recognized pregnancies at age 37 ended in miscarriage.

In the German IVF Registry, the live birth rate per embryo transfer at age 37 was 22.5%, and the clinical pregnancy rate was 31.3%. About 24% of these pregnancies ended in miscarriage. In Franasiak’s data, 42.6% of embryos at age 37 were already chromosomally abnormal, compared with 35.5% at age 36.

For elective egg freezing, the Goldman model puts the need at about 20 mature eggs at age 37 for a 75% chance. A Spanish study (Cobo 2016) shows real-world outcomes. Women who had frozen their eggs at age 36 or older and used 10 of them reached a cumulative live birth rate of 29.7%, compared with 60.5% for women up to age 35. After an average storage time of 2.1 years, only 9.3% of all women had come back to use their eggs.

In Austria, the IVF Fund pays only for certain causes: problems with the fallopian tubes, endometriosis, polycystic ovary syndrome (PCOS), or a cause in the male partner.

Getting pregnant at 38

At ages 38 and 39, the average chance per cycle in the Steiner and Jukic cohort was 13.2%, and after 12 cycles 71% had a positive test. The median time to pregnancy was 4 months, compared with 3 months under age 38. In the Wesselink cohort, 67.4% of women aged 37 to 39 became pregnant within 12 cycles.

Of the recognized pregnancies in 38-year-old women in Norway, about 19% ended in miscarriage.

After IVF or ICSI using the woman’s own eggs, the German IVF Registry counted a clinical pregnancy in 29.2% of transfers at age 38 and a live birth in 20.1%. About 26% of the pregnancies ended in miscarriage.

Elective egg freezing is possible at 38, but the model values decline. Goldman puts the need at about 25 mature eggs for a 75% chance, and with 10 eggs the model arrives at 45%. The American Society for Reproductive Medicine (ASRM) writes that ovarian reserve values such as AMH should not be used to promote elective egg freezing. According to the ASRM, age is more informative. The statutory health insurance fund pays for freezing only in the case of an illness whose treatment can damage the germ cells (Section 27a, paragraph 4, of Social Code Book V, Sozialgesetzbuch V, SGB V).

Getting pregnant at 39

The same cohort values apply at 39 as at 38: 13.2% per cycle and 71% after 12 cycles. Per cycle, that is about 30% lower than for women aged 30 to 31.

In Norway, the risk of miscarriage at age 39 was about 22%.

At age 39, the German IVF Registry counted more embryo transfers from 2019 to 2023 than at any other year of age (27,193). Of 100 transfers using the woman’s own eggs, about 26 led to a clinical pregnancy and 17 to a live birth. About 31% of these pregnancies ended in miscarriage.

Across several transfers, for ages 35 to 39 (2020 to 2023) the registry reports 32.0 clinical pregnancies per 100 patients after the first transfer and 71.2 after more than four transfers. Pregnancies are counted, not births, and one woman can be counted more than once.

In Germany, the health insurance fund checks the age limit for each treatment cycle, and what counts is the first day of the cycle or of stimulation. A cycle that begins before the 40th birthday can still be subsidized if the other requirements are met. In Austria, the age at the start of an attempt counts, and an attempt that is under way may be completed.

Getting pregnant at 40

At ages 40 and 41, the average chance per cycle in the Steiner and Jukic cohort was 8.6%. After 6 cycles, 47% of the women had a positive test, and after 12 cycles 54%. The “under 5% per cycle” figure that is often cited comes from a 2012 ASRM patient brochure that names no primary source. The 44% in the first year that is widely quoted corresponds to Leridon’s model, which counts only conceptions that later result in a birth.

In Norway, about 27% of recognized pregnancies at age 40 ended in miscarriage.

After IVF or ICSI using the woman’s own eggs, 13.4% of embryo transfers at age 40 led to a live birth and 22.5% to a clinical pregnancy (German IVF Registry). Of these pregnancies, 36.1% ended in miscarriage. An average of 6.8 eggs (IVF) or 7.0 eggs (ICSI) were retrieved per egg retrieval; at ages 35 to 39 the figures were 8.3 and 8.8.

The British NICE guideline recommends a referral to a specialist practice at the very first doctor’s appointment from age 36.

In Germany, the statutory entitlement ends at the 40th birthday. AOK Baden-Württemberg continues to pay after that if both partners are insured there and a doctor confirms in the treatment plan that there is a prospect of success and no particular risks. The BKK Kinderwunsch program pays a subsidy of €800 (IVF) or €1,000 (ICSI) after the transfer has taken place. In Austria, funding from the IVF Fund ends.

Getting pregnant at 41

For 41, Steiner and Jukic use the same age group as for 40: 8.6% per cycle and 54% after 12 cycles. In the Wesselink cohort, women aged 40 and older had a 60% lower chance per cycle than women aged 21 to 24, and 55.5% were pregnant after 12 cycles. Both groups are small (37 and 38 women, respectively).

In Norway, about 31% of recognized pregnancies at age 41 ended in miscarriage.

At age 41, after IVF or ICSI using the woman’s own eggs, a little over one in ten embryo transfers led to a live birth (11.1%, German IVF Registry). A clinical pregnancy followed 20.1% of transfers, and 40.2% of these pregnancies ended in miscarriage. In Franasiak’s data, 68.9% of embryos at age 41 were already chromosomally abnormal.

For the BKK Kinderwunsch program, 41 is the last year: eligibility lasts until the day before the 42nd birthday and applies only with participating BKK funds and clinics. You pay for medication and ancillary services yourself. Egg donation is prohibited in Germany and Switzerland. In Austria it is permitted if the woman’s own eggs are not capable of reproduction. Other European countries also allow it, under their own conditions (see age 45).

Getting pregnant at 42

For ages 42 to 44, the Steiner and Jukic cohort combines three years: 6.6% per cycle, 29% positive tests after 6 cycles and 48% after 12. The figure is based on only 14 women, and the confidence interval after 12 cycles ranges from 24% to 80%. From age 42, the median time was longer than 12 months.

In Norway, about 35% of recognized pregnancies at age 42 ended in miscarriage. An older Danish registry study (1978 to 1992) also counts ectopic pregnancies and stillbirths: there, a total of 54.5% of wanted pregnancies at age 42 ended in a loss.

After IVF or ICSI using the woman’s own eggs, 15.2% of transfers at age 42 led to a clinical pregnancy and 7.4% to a live birth, according to the German IVF Registry. Of these pregnancies, 47.1% ended in miscarriage. In Franasiak’s data, one third of 42-year-olds had no chromosomally normal embryo at all.

In Germany, at age 42 only AOK Baden-Württemberg remains, whose bylaws name no upper age limit. The wording leaves open how much it pays above age 40: the full 75% (50% insurance fund share plus 25% bylaw benefit) or only the additional 25%. Egg donation is possible in Austria until just before the 45th birthday if the woman’s own eggs are not capable of reproduction (overview of providers).

Getting pregnant at 43

The Steiner and Jukic cohort does not report individual years of age for the natural chance at any age, and from age 42 it even combines three years. For 43, the value for the age group 42 to 44 therefore applies: 6.6% per cycle and 48% after 12 cycles, based on only 14 women.

The miscarriage risk across all recognized pregnancies in Norway at age 43 was about 39%.

In the German IVF Registry, a little over half of the clinical pregnancies after IVF or ICSI at age 43 ended in miscarriage (51.2%). Per embryo transfer using the woman’s own eggs, the pregnancy rate was 11.5% and the live birth rate was 5.0%. In Franasiak’s data, 83.4% of embryos were chromosomally abnormal.

Data from the United Kingdom show the difference with egg donation. From 2018 to 2019, the live birth rate for women aged 43 to 44 was 5% per embryo transferred using their own eggs and 35% using donor eggs (HFEA). Because the British authority counts per embryo and not per transfer, the values are not directly comparable with the German registry.

The 2026 guideline from Germany, Austria, and Switzerland (the DACH guideline) recommends that women over 40 get a workup at a reproductive medicine center right away. For egg donation in Austria, the same conditions apply as at 42, and the IVF Fund does not pay the costs of the donation.

Getting pregnant at 44

For 44, too, there is only the age-group value for 42 to 44: a 6.6% chance per cycle and 48% positive tests after 12 cycles.

The risk of miscarriage in Norway at age 44 was about 46%.

At age 44, after IVF or ICSI, 3.0% of transfers led to a live birth and 8.8% to a clinical pregnancy, according to the German IVF Registry. More than six in ten of these pregnancies ended in miscarriage (61.6%). An average of 4.9 eggs (IVF) or 4.7 eggs (ICSI) were retrieved per egg retrieval. Based on egg retrieval instead of transfer, the pregnancy rate after IVF was 7.8%.

In Franasiak’s data, 88.2% of embryos at age 44 were chromosomally abnormal. Of 44-year-olds, 53% had no normal embryo at all.

For egg donation in Austria, 44 is the last possible year: treatment must begin before the 45th birthday, the woman’s own eggs must not be capable of reproduction, and the donor’s eggs may be retrieved only between her 18th and 30th birthdays. In Germany and Switzerland it remains prohibited. With the insurance fund, nothing changes compared with 42 and 43.

Getting pregnant at 45

For a natural pregnancy from age 45, the Steiner and Jukic cohort study provides no data, and there are no reliable per-cycle figures. In Norway, 53.6% of recognized pregnancies at age 45 and older ended in miscarriage.

The German IVF Registry combines all women aged 45 and older into one group. From 2019 to 2023, 3.8% of the 2,502 transfers using the woman’s own eggs led to a clinical pregnancy and 1.1% to a live birth. Of the pregnancies, 68.4% ended in miscarriage. In 2023, there were 21 pregnancies and 2 live births after 462 transfers. After 388 inseminations at age 45 and older, the German Insemination Registry (DERI) recorded no birth.

With donor eggs, the numbers look different. In the United Kingdom, the live birth rate for women aged 45 to 50 was 4% per embryo transferred using their own eggs and 30% using donor eggs (HFEA, 2018 to 2019). In 2019, 57% of women aged 45 to 50 in treatment there used donor eggs.

Legally, the options narrow from age 45. In Austria, egg donation is possible only if treatment begins before the 45th birthday. In Germany and Switzerland it is prohibited, although Switzerland plans to permit it. It is permitted in other European countries; in 2019, Spain, Czechia, and Russia reported the most egg donation cycles in Europe (ESHRE). You can find an overview of providers under egg donation.

Why the chances fall with age

Two developments run in parallel: the number of eggs declines, and the share of eggs with an abnormal number of chromosomes rises.

According to the American College of Obstetricians and Gynecologists (ACOG), 1 to 2 million eggs are present at birth, 300,000 to 500,000 at puberty, about 25,000 at age 37, and about 1,000 at age 51. A model by Wallace and Kelsey arrives at an average of 65,000 resting follicles per ovary at age 25 and 16,000 at age 35. According to the model, about 12% of the peak number remains at age 30 and about 3% at age 40, with large differences between individual women. The German IVF Registry also shows the decline: at ages 35 to 39, an average of 8.3 to 8.8 eggs were retrieved per egg retrieval, and from age 45 only 4.0 to 4.2.

In Franasiak’s data, the share of chromosomally abnormal embryos was lowest at ages 26 to 30 (20.7% to 27.1%) and was 58.2% at age 40. According to the ASRM, about 50% to 60% of miscarriages in the first trimester are due to an abnormal number of chromosomes. This was found in about half of the miscarriages examined in women under 35 and in 75% of miscarriages in women over 40 (ASRM 2026). The ASRM summarizes that fertility at 40 is about half as high as in the late 20s or early 30s. The fertile window in the cycle does not get shorter, but the chance per day falls (Dunson 2002).

The AMH level in the blood reflects the number of follicles that are maturing, not their quality. It does not predict a natural pregnancy. The study examined 750 women aged 30 to 44 with no known infertility who had been trying for no more than three months: women with a low AMH level were no less likely to have a positive pregnancy test after 12 cycles (Steiner 2017). Fixed cutoffs such as “under 1.0 ng/ml” also do not fit the reference data. In healthy women aged 40 to 44 who were not using contraception, the median in the reference study of a widely used lab test (Roche Elecsys) was 0.88 ng/ml. How the values are distributed by age is shown in our AMH Chart.

How long does it take to get pregnant at 40?

In the Steiner and Jukic cohort, the median time until a positive pregnancy test was as follows:

Median means: half of the women were pregnant by then, and the other half later or not at all. After 12 cycles, 54% of 40- to 41-year-olds had a positive test. In the Wesselink cohort, the figures for women aged 40 and older were 27.6% after 6 cycles and 55.5% after 12 cycles.

Leridon’s 2004 calculation model looks at longer time periods and counts only conceptions with a later live birth. According to the model, when starting at age 40, 44% achieve this in the first year and 64% within four years; when starting at 35, the figures are 66% and 84%. familienplanung.de gives the same first-year figures without citing a source and describes them as “pregnant.” According to the model, fertility treatment makes up for only part of the births lost by trying later: when postponing from 35 to 40, less than 30%.

For couples with a woman aged 35 to 39, the British NICE guideline gives pregnancy figures of 82% after one year and 90% after two years. Its table contains no values for women over 39. According to Dunson (2004), among women aged 35 to 39, depending on the man’s age, 18% to 28% of couples did not become pregnant within 12 cycles. Of the couples without a pregnancy in the first year, 43% to 63% became pregnant in the second year.

The figures differ because the studies count different things. Steiner and Wesselink count positive tests, while Leridon counts only conceptions with a later birth.

Pregnancy risks by age

Two risks can be described well in numbers for each year of age: miscarriage and trisomy 21 in the child.

Sources: Magnus et al. 2019, Norway 2009 to 2013, individual years read from a chart. Morris et al. 2002 with 2005 correction: frequency at live birth without prenatal diagnosis and pregnancy termination, England and Wales 1989 to 1998, calculated from the model formula. For comparison: 1 in 1,340 at age 25, 1 in 939 at age 30.

An older Danish registry study found a share of 40.8% spontaneous miscarriages for ages 40 to 44 and 74.7% from age 45. It records only miscarriages with hospital admission.

Earlier miscarriages also play a role. In Norway, 11.6% of pregnancies in women with no previous pregnancy ended in miscarriage. After an immediately preceding miscarriage the figure was 19.8%, after two in a row 27.7%, and after three or more in a row 41.9% (Magnus 2019). Our article Getting pregnant after a miscarriage explains how things can continue after a loss.

The information for insured people from the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA) on the blood test for trisomies calculates per 10,000 pregnancies instead of per birth, and in coarser age groups. For pregnant women aged 35 to 39, it gives 52 cases of Down syndrome, 10 of trisomy 18, and 4 of trisomy 13, and for those over 40, 163, 41, and 10. These values cannot be combined with the table above.

According to ACOG, gestational diabetes, high blood pressure, and preeclampsia also occur more often from age 35, as do cesarean deliveries. In Germany, the G-BA’s maternity guidelines (Mutterschafts-Richtlinie) name first-time mothers over 35 and women over 40 who have given birth before as examples of pregnancies that need special monitoring, colloquially called a high-risk pregnancy. The same applies there to a pregnancy after fertility treatment. Whether that applies is assessed by the doctor in each individual case. More frequent prenatal checkups may then be appropriate. Talk to your gynecologist about which prenatal care makes sense for you.

When to see a doctor

Professional societies tier their recommendation by the woman’s age:

• ASRM (2021 and 2023): a workup after 12 months without a pregnancy, and from age 35 after 6 months. Over 40, a faster workup and treatment may be indicated.
• Guideline of the German, Austrian, and Swiss gynecology societies (DGGG, OEGGG, and SGGG; S2k, version 2.0, 2026): 12 months, over 35 already 6 months, over 40 an immediate workup at a reproductive medicine center.
• familienplanung.de (Federal Institute for Public Health): for women aged 35 and older after 6 months.
• NICE NG257 (2026): from age 36, a referral to a specialist practice at the very first doctor’s visit.
• ACOG (2025) restates the ASRM rule this way: up to 35 after one year, 36 to 40 after 6 months, over 40 immediately. The age limits are shifted by one year there. However, this tiering does not appear in this form in the 2023 ASRM statement to which ACOG refers.

With an irregular cycle or known risks such as endometriosis, an earlier appointment makes sense. Our infertility guide explains what can be behind infertility. The time limits are medical recommendations, not insurance fund rules. According to familienplanung.de, the statutory health insurance fund pays in full for tests to find the cause of infertility. Which individual services some practices nevertheless bill privately, such as checking the fallopian tubes by ultrasound, is explained in the article on the fertility test for women. For IVF or ICSI, the fund additionally requires counseling from a doctor who is not providing the treatment and a referral to an approved clinic (Section 27a of Social Code Book V). You do not always need a referral for a first appointment at a fertility practice.

Tests to have beforehand

Our article on the fertility test for women explains what is examined during the workup and what it costs. For infertility, the guideline of DGGG, OEGGG, and SGGG (version 2.0, 2026) names the following as the basis: hormone levels on cycle days 2 to 5, namely LH, FSH, TSH, prolactin, total testosterone, DHEAS, SHBG, estradiol, and AMH, plus a transvaginal ultrasound with a count of the small follicles (antral follicle count, AFC). If needed, a check of the fallopian tubes follows, usually by contrast ultrasound (HyCoSy). If a blockage is suspected, or in the case of infection, endometriosis, or a previous ectopic pregnancy, the guideline recommends laparoscopy with hysteroscopy. For the partner, a semen analysis is part of the workup.

In women without infertility, the AMH level is not informative, or only to a very limited extent, according to a statement by DGGEF, DGRM, and BVF. In women who were on the pill, it was on average 19% lower in one study (Birch Petersen 2015).

When it comes to trying to conceive, a Cochrane review (2023) shows that intercourse after a positive urine ovulation test probably increases the live birth rate in women under 40 who have been trying for less than 12 months. Our Ovulation Calculator gives you a first idea of your fertile days. In its 2026 version, the Healthy Start network (Gesund ins Leben) recommends that women trying to conceive take 400 µg of folic acid per day in addition to their diet, from the time they start trying to conceive until the end of the 12th week of pregnancy. Anyone who does not start at least 4 weeks before conception takes 800 µg. The same dose applies with overweight. Details are in the article Folic acid when trying to conceive.

Treatments and legal situation in Germany, Austria, and Switzerland

Cycle monitoring

The simplest step is cycle monitoring by ultrasound so that intercourse is timed to ovulation. Sometimes ovulation is supported with clomiphene or letrozole. Letrozole is not approved for this use in Germany and is used off label.

IUI

In intrauterine insemination (IUI), prepared sperm are placed directly into the uterus. The German Insemination Registry (DERI) analyzes inseminations with the partner’s sperm by age. From 2019 to 2023, they led to a clinical pregnancy in 9.7% and to a live birth in 5.7% at ages 35 to 39. At ages 40 to 44, the figures were 6.4% and 2.5%. In Switzerland, IUI is the only fertility treatment that mandatory basic health insurance pays for, up to three cycles per pregnancy. More under IUI treatment.

IVF and ICSI

IVF and ICSI are the procedures with the most data, and the values by year of age are above. Across several transfers, the German IVF Registry (2020 to 2023) reports these cumulative clinical pregnancies per patient:

Pregnancies are counted, not births, and one woman can be counted more than once. The values are therefore an upper limit for the share of women who became pregnant. The difference between the procedures is explained in ICSI vs. IVF, and the process in our guide to assisted reproduction. The IVF Calculator gives you an orientation based on the registry data.

PGT-A

In PGT-A, embryos are tested for the number of their chromosomes before transfer. In Germany, this is permitted only in narrow exceptional cases after approval by an ethics committee (Section 3a of the Embryo Protection Act, Embryonenschutzgesetz), and screening solely because of age is not provided for. Austria permits the testing only after three or more transfers without a pregnancy when a genetic cause is suspected, after at least three miscarriages or stillbirths with a probable genetic cause, or in the case of a serious hereditary risk. Switzerland permits it to detect chromosomal characteristics that can impair the embryo’s development. More under preimplantation genetic testing.

Egg donation

In Germany, egg donation is prohibited (Section 1 of the Embryo Protection Act). Health Minister Warken plans a partial authorization for surplus eggs from fertility treatments; according to the German Medical Journal of February 27, 2026, there was no draft bill. In Austria, it has been permitted since the 2015 reform if the woman’s own eggs are not capable of reproduction and treatment begins before the 45th birthday. In Switzerland it is prohibited; the Federal Council wants to permit it, and the consultation procedure is planned for the second quarter of 2027. In Europe in 2019, according to ESHRE, 50.5% of fresh transfers using freshly donated eggs led to a pregnancy (not a birth), and the recipient’s age had little influence. You can find an overview of providers under egg donation.

Costs and insurance coverage by age

Until the 40th birthday, the statutory health insurance fund in Germany contributes 50% toward up to three IVF or ICSI attempts, and in Austria the IVF Fund contributes 70% toward up to four attempts. After that, you generally pay the costs yourself, with the exceptions of AOK Baden-Württemberg and the BKK Kinderwunsch program (see age 40 and age 41). With private health insurance, reimbursement depends on the contract and on whose side the cause lies. In Switzerland, mandatory basic health insurance does not pay for IVF at any age.

You can calculate what a treatment costs and what share your fund pays with the cost calculator. The prices of all procedures are in the fertility cost guide, and the funds’ benefits under cost coverage. Costs you pay yourself can, under some circumstances, be deducted from your taxes. You can find clinics in our clinic directory, and the Fertility Clinic Finder helps you work out your next step.

Frequently asked questions

What are the chances of getting pregnant at 40?

In a US cohort of women with no known infertility, the average chance per cycle at ages 40 to 41 was 8.6%. After 12 cycles, 54% had a positive test (Steiner and Jukic 2016). After IVF or ICSI using the woman’s own eggs, 13.4% of embryo transfers in Germany at age 40 led to a live birth (German IVF Registry, fresh cycles 2019 to 2023). Your own situation may look different.

Can you still get pregnant naturally at 40?

Yes, but less often than in the mid-30s. In a US cohort of women with no known infertility (Steiner and Jukic 2016, 37 women aged 40 to 41), half had a positive pregnancy test after 8 months, and 54% had one after 12 cycles. Pregnancies that ended early are also counted. The British NICE guideline recommends involving a specialist practice early from age 36.

What is the risk of miscarriage at 40?

In Norway, about 27% of recognized pregnancies at age 40 ended in miscarriage, and in the group aged 40 to 44 the figure was 32.2% (Magnus 2019). After IVF or ICSI, the share at age 40 was 36.1% according to the German IVF Registry. The two values come from different groups and are not directly comparable.

What are the chances of getting pregnant at 39?

At ages 38 to 39, the average chance per cycle in a US cohort of women with no known infertility (Steiner and Jukic 2016, 61 women) was 13.2%, and after 12 cycles 71% had a positive test. The median time was 4 months. After IVF or ICSI using the woman’s own eggs, 17.0% of embryo transfers in Germany at age 39 led to a live birth (German IVF Registry, fresh cycles 2019 to 2023).

How many women get pregnant at 42?

In a US cohort of women with no known infertility (Steiner and Jukic 2016), 48% of women between 42 and 44 had a positive test after 12 cycles. The group was very small, with 14 women, and the confidence interval ranges from 24% to 80%. After IVF or ICSI using the woman’s own eggs, 15.2% of transfers in Germany at age 42 led to a clinical pregnancy and 7.4% to a live birth (German IVF Registry, fresh cycles 2019 to 2023).

Am I too old to have a child at 43?

No statistic can answer that for you, because the decision is personal. The data show lower chances than in the mid-30s: after IVF or ICSI using the woman’s own eggs, 5.0% of embryo transfers at age 43 led to a live birth, and in Norway about 39% of recognized pregnancies in 43-year-olds ended in miscarriage. A fertility practice can talk with you about which paths are open to you, including egg donation in Austria until just before the 45th birthday.

Can you still get pregnant at 45?

It is possible, but rare. After IVF or ICSI using the woman’s own eggs, 1.1% of embryo transfers in Germany at age 45 and older led to a live birth (2019 to 2023); in 2023 there were 2 live births after 462 transfers. With donor eggs, the live birth rate in the United Kingdom at ages 45 to 50 was 30% per embryo transferred (HFEA, 2018 to 2019). In Germany and Switzerland, egg donation is prohibited.

At what age is a pregnancy considered high-risk?

In Germany, the G-BA’s maternity guidelines (in effect since August 25, 2026) name first-time mothers over 35 and women over 40 who have given birth before as examples of pregnancies that need special monitoring, colloquially called a high-risk pregnancy. The doctor makes the classification in each individual case. According to ACOG, among other things gestational diabetes, high blood pressure, and chromosomal abnormalities occur more often from age 35. A higher risk in the statistics does not mean that your pregnancy will be difficult.

Is it true that fertility drops rapidly after 35?

The chances fall noticeably after 35, and according to the ASRM, fertility at 40 is about half as high as in the late 20s or early 30s. In a US cohort of women with no known infertility (Steiner and Jukic 2016), the chance per cycle was 16.2% at ages 34 to 35 and 8.6% at ages 40 to 41. Individual women differ greatly from this, both upward and downward.

Until what age can I have IVF?

The German IVF Registry also records treatments from age 45; from 2019 to 2023 there were 2,502 transfers. The live birth rate per transfer was 3.0% at age 44 and 1.1% from age 45. Insurance contributions end at the 40th birthday in Germany and Austria, with AOK Baden-Württemberg and the BKK Kinderwunsch program as exceptions. Switzerland has no fixed age limit, and IVF is not an insurance benefit there at any age.

Is elective egg freezing still worthwhile after 35?

That depends on your age and your life plans, not on a single lab value. In Goldman’s calculation model, it takes about 20 mature eggs at age 37 for a 75% chance of at least one live birth, and about 40 at age 40. The authors themselves consider the model values possibly too optimistic. In Cobo’s study, among 27 women who had frozen their eggs from age 40 and later used them, there was one child. More in the elective egg freezing guide.

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