IVF After 40: What the CDC Data Shows

Many people start fertility treatment after 40, and they deserve clear numbers. This guide sets out what the CDC’s 2022 data shows for IVF in this age group, with own eggs and with donor eggs. It also covers how many cycles patients typically go through and how much clinics differ.^[1] It describes data and does not replace advice from a clinician who knows your history.

How common is IVF after 40?

Patients over 40 account for a large share of US fertility treatment. In 2022, clinics reported 86,880 ART cycles for patients over 40, out of 435,426 in total, or 20%.^[1]

Live-birth rates with your own eggs

For patients over 40 using their own eggs, nationally:^[1]

Measure (own eggs, over 40)	2022
Live births per intended egg retrieval	7.7%
Live births per actual retrieval	9.4%
Live births per transfer	25.4%
New patients: live birth after 1 intended retrieval	8.5%
New patients: live birth after all intended retrievals	13.4%
Intended retrievals with no eggs retrieved	15.2%

Two things stand out. First, the per-transfer rate (25.4%) is much higher than the per-retrieval rate (7.7%), because many cycles stop before a transfer.^[1] If a clinic quotes a per-transfer figure, ask for the per-retrieval figure too. Second, the gap between the 38–40 group (23.1%) and the over-40 group is large, so “over 40” is a very different starting point from “late 30s”.^[1]

Note that the CDC’s oldest band is “over 40”, a single group. Outcomes at 41 and at 45 are not shown separately in clinic-level data. Professional bodies describe fertility as continuing to decline with each year in this range.^[3]

How many cycles do patients go through?

New patients over 40 had on average 1.6 intended retrievals in the reporting period, compared with 1.2 for those under 35.^[1] The cumulative live-birth rate for new patients over 40 rose from 8.5% after one intended retrieval to 11.7% after one or two.^[1] Repeated cycles add some chance of success, but each one adds cost and time, and the effect is smaller than in younger groups.

Donor eggs

Donor eggs, usually from younger donors, are an option many patients over 40 consider. CDC reports donor-egg outcomes per transfer for all ages combined, because the donor’s age matters more than the recipient’s:^[1]

Donor type (all recipient ages)	Transfers	Live births per transfer
Fresh embryos from fresh donor eggs	791	52.0%
Fresh embryos from frozen donor eggs	2,576	45.2%
Frozen embryos from donor eggs	18,678	45.1%
Donated embryos	3,296	42.2%

These per-transfer rates cannot be compared directly with per-retrieval rates for own eggs. They start counting at a later step. Still, donor-egg transfers have markedly higher live-birth rates than own-egg treatment over 40.^[1] Among clinics that reported to the CDC for 2022, 400 of 451 (88.7%) offered donor-egg services.^[1] See donor egg IVF success rates for more detail.

How clinics compare for patients over 40

Only some clinics treat enough patients over 40 to show a stable rate. In the CDC data, 296 clinics reported at least 20 intended retrievals for patients over 40 with a published rate. Among them, the median clinic’s live-birth rate per intended retrieval was 8.2%, and the middle half of clinics ranged from 5.5% to 12.0%.^[1]

A higher rate over 40 can reflect which patients a clinic accepts. A clinic that turns away people with a poor prognosis will show better numbers. The CDC cautions against reading clinic differences as differences in quality.^[2] Every clinic page on FertilityList shows its over-40 figures next to the national rate, with the number of cycles behind them.

Practice patterns over 40

Clinics also differ in how they treat older patients, and the CDC data shows some of this. Nationally, 52.9% of transfers for patients over 40 involved at least one embryo that had preimplantation genetic testing (PGT), and 83.4% used frozen embryos.^[1] These practices change how many cycles reach a transfer and what the per-transfer rate looks like. Whether they improve the overall chance of a baby for a particular patient is a question to discuss with a clinician; the CDC data describes practice, not its effect on any one person.

Some patients over 40 freeze eggs or embryos across several retrievals before attempting a transfer, sometimes called “banking”. In the CDC data, 4.7% of cycles for patients over 40 were for fertility preservation, meaning eggs or embryos were stored rather than transferred in that cycle.^[1] Such cycles are counted in the cumulative measures once a transfer happens within the CDC’s one-year window.

Questions worth asking a clinic

• How many patients over 40 did you treat last year, and what were their live births per intended retrieval?
• Do you have age cut-offs for using one’s own eggs?
• How do you decide whether to recommend own eggs or donor eggs, and what are the donor-egg results at your clinic?
• How many cycles do patients over 40 typically do with you before changing approach?

More in our guide to questions to ask a fertility clinic.

Bottom line

The CDC data shows that IVF after 40 with one’s own eggs leads to a live birth in a minority of cycles. Outcomes differ greatly between 38–40 and over 40, and donor-egg treatment has substantially higher per-transfer success.^[1] IVF itself is a multi-step process with medication, egg retrieval and embryo transfer.^[4] The right path depends on individual factors only a clinician can assess.

Compare clinics in your state.