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It has been very well documented that fertility rates decrease with age in women. However, there appears to be a grey zone as to when this decrease commences. It would appear in general that this decline becomes pronounced over the age of 35 due to a decreased ovarian reserve. There have been numerous ways of assessing ovarian function including baseline estradiol and FSH levels, clomiphene citrate challenge test (CCCT), and GnRH agonists stimulation testing. These tests do have their drawbacks, however they appear to be a better indicator of ovarian reserve than age alone. Furthermore, there also appears to be a decline in endometrial receptivity with age although this is not as pronounced as the decrease in ovarian reserve. This decline in endometrial receptivity can be ameliorated to some extent by giving superphysiologic doses of progesterone.