Trying to conceive at 40: what you can do now

Trying to conceive at 40 is possible, but it often takes longer: 1177 says it is common for it to become harder from around 35 and much harder after around 40 [1]. That’s why time is the most important thing to plan for. Take care of what you can influence, and contact your vårdcentral or a fertility clinic early rather than waiting a full year [2].

If it is taking longer than you expected, you are not alone. Below I go through what changes with age, what you can do yourself and how the care system in Stockholm works.

What changes with age

Fertility declines with age [2]. This is the one factor that no plan can change, which is why time matters so much at 40.

There’s no single age when everything changes. 1177 describes it as a gradual shift: harder from around 35, much harder after around 40 [1]. How it looks for you depends on your health, your cycle and your partner’s fertility too.

I won’t give you percentages here. Averages from large groups say little about you as one person, and they tend to cause more worry than clarity. What they do say clearly is this: at 40, it pays to act early.

Can a test tell you how much time you have?

Many people ask me about AMH (anti-Müllerian hormone), often called an “egg reserve” test. It’s an understandable question, because a number feels concrete.

A US study funded by the National Institutes of Health followed women aged 30 to 44 with no known fertility problems. Women with low AMH conceived naturally at similar rates to women with normal AMH [4]. The researchers concluded that these tests don’t predict natural fertility in that group [4].

So a low AMH result is not a verdict. It can still be useful for a fertility clinic, for example when planning IVF. Ask your doctor what your result means before you draw conclusions.

What you can do yourself

Age is the one factor no one can change. Several others are worth looking at, for both you and your partner.

Timing. You’re most likely to get pregnant around ovulation, which usually happens about 14 days before your next period [3]. The NHS suggests sex every 2 to 3 days through the cycle, rather than only on the days you think you ovulate [3]. That takes some pressure off timing.

Supplements. The NHS lists vitamin D and folic acid among the things that can help when you’re trying [3]. Ask your vårdcentral or me which dose fits you.

Weight. Weight that is too low or too high can make it harder to get pregnant [3]. A BMI of 30 or over reduces fertility [2]. If this is relevant for you, we look at food and meal rhythm together, without strict diets.

Smoking and alcohol. Smoking, including passive smoking, affects your chance of conceiving and can reduce semen quality [2]. 1177 advises avoiding alcohol, tobacco and other drugs when you’re trying [1].

Your partner. Fertility is a shared question. Smoking can reduce semen quality [2], so the advice on habits applies to your partner as well.

None of this replaces a fertility assessment. It gives your body better conditions while the clock is ticking.

How the care system works in Stockholm

This is the part I most want expat readers to know, because it isn’t obvious.

In Stockholm, you can seek public care for involuntary childlessness after at least one year of trying [1]. You contact a vårdcentral (local primary care clinic), a gynecology clinic, a women’s clinic or a fertility clinic [1]. The investigation includes several tests, and in Stockholm it is sent on to Reproductive Medicine at Karolinska University Hospital [1].

The NHS advice is different: women aged 36 and over should see their doctor sooner [2]. At 40, a year of waiting is a long time. My suggestion is to call 1177 or your vårdcentral early, explain your age and ask what applies to you. Private fertility clinics are another route you can ask about.

Acupuncture: what the research says

I want to be honest here. A Cochrane review from 2013 found no evidence that acupuncture improves live birth or pregnancy rates in assisted conception, and the certainty of the evidence was low [5]. The review didn’t find significant side effects either [5].

I see acupuncture as one part of a plan, often for sleep, stress and how you feel in your body during a demanding time. Not as a way to get pregnant. You can read more in acupuncture and fertility.

How I work with you

At your first visit, we go through your whole story: cycle, periods, sleep, stress, food, digestion, earlier lab results and what you’ve already tried. The visit is 60 minutes and costs 3,500 SEK, at Kommendörsgatan in Östermalm or online, in English or Swedish.

After the visit, you get a written plan. It can include advice on food, sleep and stress, Chinese and Western herbs, supplements and acupuncture, mainly Japanese style. If it makes sense, we order tests through a private lab, with functional testing alongside conventional tests. The results become information to bring to your doctor or fertility clinic.

I work in parallel with your doctor or clinic, who are in charge of the fertility assessment and any treatment. If you’re preparing before you start, my preconception checklist is a good place to begin. You’ll find more on my fertility page and every visit option on prices.

When to see a doctor

Contact your vårdcentral (local primary care clinic) or call 1177 (Sweden’s public health information service) if you:

• are 40 and have started trying, so you can plan your route to an investigation early [1][2]
• have been trying for a year or more [1][3]
• have irregular periods or no periods
• have severe period pain, very heavy bleeding or bleeding between periods
• have had complications after abdominal surgery [1]
• you or your partner take prescribed or over-the-counter medicines or herbal remedies [3]

Call 112 if you have sudden, severe pain in your lower abdomen, especially with dizziness or fainting.

Sources

1. 1177. Ofrivillig barnlöshet, Stockholm County (updated 2026, accessed 9 November 2026). https://www.1177.se/stockholm/barn--gravid/barnloshet/ofrivillig-barnloshet/
2. NHS. Infertility (accessed 9 November 2026). https://www.nhs.uk/conditions/infertility/
3. NHS. Trying to get pregnant (accessed 9 November 2026). https://www.nhs.uk/pregnancy/trying-for-a-baby/trying-to-get-pregnant/
4. NICHD, National Institutes of Health. Ovarian reserve tests fail to predict fertility, NIH-funded study suggests. 2017. https://www.nichd.nih.gov/newsroom/releases/101017-ovarian-reserve
5. Cochrane. Acupuncture and assisted conception (systematic review), 2013. https://www.cochrane.org/CD006920/MENSTR_acupuncture-improving-live-birth-rates-women-undergoing-assisted-reproductive-technology