Reproductive ageing in women is caused by declining number and quality of oocytes. The Royal College of Obstetricians and Gynaecologists (RCOG) should promote the view of a shared responsibility in addressing the problems associated with reproductive ageing and encourage an acknowledgement that personal and social circumstances play a role rather than placing blame on individuals. The RCOG should urge greater transparency and accuracy in depicting assisted reproductive technology success rates, including the cost and clinical efficiency of full cycles (full cycle implies cryopreservation of embryos). There are no contraceptive methods contraindicated by age alone. Older women may use combined hormonal contraception unless they have co-existing diseases or risk factors. Further research is needed into characterisation of existing and novel ovarian biomarkers to provide clinically useful prediction of current and future fertility. National data collection covers live births and terminations of pregnancy but should be expanded to include information about miscarriage.