Dr Moses Abe
MBBS, FRCPI (Ireland), FRCOG (UK), FRANZCOG (Aus/NZ)
Monash IVF
Dr Moses Abe
MBBS, FRCPI (Ireland), FRCOG (UK), FRANZCOG (Aus/NZ)
Monash IVF
After all these years in reproductive medicine, one thing has remained constant: women ask thoughtful, important questions about fertility, timing, and the choices before them.
The availability of information today has been a great advance. But information alone is not enough. What is often lacking is the ability to conceptualise that information clearly and place it in the right clinical and personal context. Without that, information can lead not to empowerment, but to anxiety.
So I took time out of my busy schedule to write a practical, honest guide based on the real questions and concerns I hear in clinical practice from women navigating fertility in their 30s and beyond.
It feels like having a conversation with a specialist who is truly on your side.
If you are carrying a question that matters deeply to you, this book was written for you.
Perhaps you are wondering whether age is already working against you. Perhaps you have been given test results without the context to make sense of them. Perhaps you have spent an evening searching the internet and come away more frightened than informed. You are not alone in that experience, and you are not foolish for feeling uncertain.
The truth is that there is no shortage of fertility information available today. What is often missing is the clinical perspective needed to place that information in context. Without it, numbers can mislead, reassurance can ring hollow, and anxiety can fill the space where understanding should be.
This book is my attempt to close that gap. Drawing on more than thirty years of clinical practice as a fertility specialist, I have written the kind of guide I wish every woman could take home after a consultation: grounded in evidence, honest about uncertainty, and free from the scaremongering and false promises that too often dominate this conversation.
The book is structured around the way women actually experience fertility questions, not as a textbook, but as a conversation that meets you where you are.
It begins with the foundations: why the age of 35 has become such a loaded number, what fertility actually depends on beyond age alone, and how to separate evidence from the myths and mixed messages that circulate online and in well-meaning advice.
It then follows the reproductive timeline as women live it — from the late twenties, when concern often arrives before readiness, through the early thirties when planning starts without a clear map, into the mid-thirties when clarity matters more than comfort, to around 40 when urgency becomes real, and into the mid-to-late forties when the conversation shifts toward truth, grief, and new pathways forward.
The book addresses the practical decisions that matter most: understanding the tests women hear about (including AMH and what it does and does not tell you), navigating primary and secondary subfertility, recurrent miscarriage, what you can still do to protect your fertility, and treatment options explained without fantasy. It also covers cross-border reproductive care and the ethical considerations involved.
Finally, it does something many fertility books avoid: it speaks with honesty and compassion about what happens when pregnancy does not come, and how to move forward with dignity, clarity, and hope.
Dr Moses Abe is a fertility specialist with more than thirty years of clinical experience in reproductive medicine and gynaecology. A Fellow of the Royal Colleges of Obstetricians and Gynaecologists of Ireland, the United Kingdom, and Australia and New Zealand, he practises through Melbourne Fertility Clinic and is affiliated with Monash IVF.
Women’s Fertility After 35 draws directly on the questions, concerns, and clinical conversations that have shaped his practice. It is the book he wished every patient could take home.
No. The age of 35 is a useful clinical marker, but it does not represent a cliff edge for fertility. Many women conceive naturally or with assistance well into their late thirties and beyond. What changes gradually after 35 is the balance between egg quantity and egg quality, which means that fertility awareness and timely assessment become more important. The real question is not whether 35 is “too late” but whether your individual biology, health, and circumstances have been properly assessed. A fertility specialist can help you understand where you stand and what your realistic options are.
The most important recommendation is not to rely on general statistics or internet advice alone. Every woman’s fertility picture is shaped by a combination of factors including ovarian reserve, egg quality, reproductive history, underlying conditions such as endometriosis or PCOS, and lifestyle.
A specialist assessment typically includes blood tests such as AMH, an ultrasound to check your antral follicle count, and a detailed review of your medical history. From there, your specialist can offer guidance tailored to your specific situation rather than a one-size-fits-all approach.
Anti-Müllerian Hormone (AMH) is a blood test that provides an indication of your remaining egg quantity. It is one of the most commonly requested fertility tests and can be helpful in understanding your ovarian reserve. However, AMH does not measure egg quality, and it is not a fertility test in isolation. A low AMH does not mean you cannot conceive, and a normal AMH does not guarantee that you will. The value of AMH lies in how it is interpreted alongside your age, your antral follicle count, your medical history, and the broader clinical picture.
Egg freezing can be a valuable option for women who are not yet ready to conceive but want to preserve their fertility for the future. The decision depends on several factors including your current ovarian reserve, your age, your personal circumstances, and your understanding of what egg freezing can and cannot promise. It is not a guarantee of future pregnancy, and the success rates are directly related to the age at which the eggs are frozen and the number retrieved. A consultation with a fertility specialist can help you weigh the benefits, the realistic expectations, and whether it is the right step for you.
If you have been trying to conceive for twelve months without success (or six months if you are over 35), a fertility assessment is a reasonable next step. However, you do not need to wait for a specific milestone to seek advice. If you have irregular periods, a known condition such as endometriosis or PCOS, a history of miscarriage, or concerns about your reproductive timeline, an earlier conversation with a specialist can provide clarity. Fertility treatment is not always IVF. Depending on your situation, options may include ovulation tracking, ovulation induction, or other approaches tailored to your diagnosis.
Women’s Fertility After 35 by Dr Moses Abe is written specifically for women navigating fertility decisions in their thirties and beyond. Unlike general fertility guides, it is grounded in more than thirty years of clinical practice in Australia and addresses the real questions women bring to the consulting room. The book covers the foundations of fertility, the reproductive timeline from the late twenties through to the mid-forties, testing and treatment options explained without fantasy, and the emotional dimensions of the journey including what happens when pregnancy does not come. It is available in paperback and Kindle on Amazon Australia.
No. The age of 35 is a useful clinical marker, but it does not represent a cliff edge for fertility. Many women conceive naturally or with assistance well into their late thirties and beyond. What changes gradually after 35 is the balance between egg quantity and egg quality, which means that fertility awareness and timely assessment become more important. The real question is not whether 35 is “too late” but whether your individual biology, health, and circumstances have been properly assessed. A fertility specialist can help you understand where you stand and what your realistic options are.
The most important recommendation is not to rely on general statistics or internet advice alone. Every woman’s fertility picture is shaped by a combination of factors including ovarian reserve, egg quality, reproductive history, underlying conditions such as endometriosis or PCOS, and lifestyle.
A specialist assessment typically includes blood tests such as AMH, an ultrasound to check your antral follicle count, and a detailed review of your medical history. From there, your specialist can offer guidance tailored to your specific situation rather than a one-size-fits-all approach.
Anti-Müllerian Hormone (AMH) is a blood test that provides an indication of your remaining egg quantity. It is one of the most commonly requested fertility tests and can be helpful in understanding your ovarian reserve. However, AMH does not measure egg quality, and it is not a fertility test in isolation. A low AMH does not mean you cannot conceive, and a normal AMH does not guarantee that you will. The value of AMH lies in how it is interpreted alongside your age, your antral follicle count, your medical history, and the broader clinical picture.
Egg freezing can be a valuable option for women who are not yet ready to conceive but want to preserve their fertility for the future. The decision depends on several factors including your current ovarian reserve, your age, your personal circumstances, and your understanding of what egg freezing can and cannot promise. It is not a guarantee of future pregnancy, and the success rates are directly related to the age at which the eggs are frozen and the number retrieved. A consultation with a fertility specialist can help you weigh the benefits, the realistic expectations, and whether it is the right step for you.
If you have been trying to conceive for twelve months without success (or six months if you are over 35), a fertility assessment is a reasonable next step. However, you do not need to wait for a specific milestone to seek advice. If you have irregular periods, a known condition such as endometriosis or PCOS, a history of miscarriage, or concerns about your reproductive timeline, an earlier conversation with a specialist can provide clarity. Fertility treatment is not always IVF. Depending on your situation, options may include ovulation tracking, ovulation induction, or other approaches tailored to your diagnosis.