Women's Fertility After 35: A Specialist's Honest Guide to Fertility, Age, and the Decisions That Matter

A fertility specialist's honest answer to the question you are actually asking.

You are past thirty-five. Someone has told you that your eggs are old. Someone else has told you not to worry. A test result has arrived with a number on it that nobody has properly explained. And underneath all of it sits the only question that matters: how much time do I have, and what should I do with it?

Dr Moses Abe has spent three decades in fertility clinics and on labour wards-in Britain, Ireland and Australia-sitting across the table from women asking exactly that. This book is the conversation he has with them: unhurried, specific, and free of both the panic and the false comfort that dominate almost everything else written on the subject.

INSIDE THIS BOOK

• what actually changes after thirty-five, and what does not
• how to read AMH, antral follicle count and the other numbers you will be handed
• when to wait, when to test, and when to treat
• IVF, egg freezing and donor eggs-what each can and cannot do at your age
• miscarriage, recurrent loss, and the risks that are rarely explained properly
• endometriosis, fibroids and PCOS, and how each changes the timeline
• the male half of the picture, which is routinely ignored
• pregnancy after thirty-five: what the risks really are, in numbers you can use
• the questions to ask at your next appointment, and the answers you should expect
• which decisions are medical, and which are only ever yours

FOR THE WOMEN-AND FOR THOSE WHO CARE FOR THEM

This book was written for the woman in the waiting room. It was also written with her clinicians in mind. Fertility nurses, general practitioners, obstetricians and gynaecologists, reproductive medicine trainees, embryologists, midwives, fertility counsellors and psychologists will find here a single coherent account of what the evidence supports, where it stops, and how to say it out loud without either alarming a patient or patronising her. The hard part of this work is rarely knowing the science. It is explaining it to a frightened person in twenty minutes. This is a book about how that conversation should go-useful in the clinic, in teaching, and in preparation for examinations.

WHY THIS BOOK IS DIFFERENT

Most fertility writing does one of two things. It frightens, or it soothes. Neither helps a woman decide anything. This book assumes you are an adult who can be told the truth, including the parts that are uncertain, and including the parts where medicine has less to offer than it likes to imply. The chapters are short and can be read in the order you need them rather than front to back.

Honesty is not the same as bluntness. Nothing here is designed to push you towards treatment or to talk you out of hope. It is written by a doctor who has delivered the babies, run the cycles, and sat with the women for whom it did not work-and who believes you are owed the same information he would give a colleague.

If you have been offered either alarm or platitudes, this is the third thing: a specialist telling you the truth, and then leaving the decision where it belongs.