Worldwide more than 70 million couples suffer from infertility. Human fertility rates have declined all over the world, including both developed and developing countries. Infertility is a distressing issue for the couples and their families and even impacts on the local community. According to the World Health Organization (WHO), infertility is a global health problem and its negative psychological consequences of childlessness are common and often severe. Thus, the decreasing trends in fertility rates in many countries are now remarkable that necessitate for more scientific attention. Several factors influence fertility decline that some of these factors are unknown. It is generally assumed that these declining trends are due to social and economic factors such as woman’s working careers, their education and better contraception. One of these factors is age and an age-related decline in fertility is observed in natural fertility and also artificial insemination. The decreasing usually starts at 32 years and a marked decline in fecundity and fertility rates occurs in women older than 35 years.It seems one of factors that may be contribute to this trend is a general lack of knowledge about the decline in fertility with age. Recently, it has been shown a 13% increase in the use of assisted reproduction technology (ART) services. Increasing female age decreases the chance of live birth rates achieved using ART and ageing has negative impact on ART outcome, especially after 40 years of age. Even some IVF centers refuse women over the age of 40 years because of the natural decline in fertility with age and the higher incidence of genetic anomalies in infants of these women. Age is perhaps the single most important factor in assessing an ovarian reserve. Moreover, several indirect biomarkers have been recognized to assess ovarian reserve. Some of these factors include: Follicle Stimulating Hormone (FSH): In women with a decreased ovarian reserve, through the feedback mechanism, low levels of inhibin B cause high levels of serum FSH in the early follicular phase. FSH levels higher than 20 mIU/ml are related to poor pregnancy outcomes. Although elevated levels of basal FSH predict a lower oocytes number and poor IVF success, it is better to be used from elevated basal FSH in counseling couples prior to ART but should not be used to cancellation of ART procedures.Anti-Mullerian Hormone (AMH): AMH is produced by granulose cells from pre-antral and antral follicles. Serum AMH levels essentially reflect the ovarian follicular pool. AMH levels do not significantly change throughout the menstrual cycle and allow measurement any time of the cycle. Reduction in the number of small growing follicles, especially in the late reproductive period, may be followed by a reduction in serum AMH levels. Recently, clinical application of AMH levels measurement are proposed for the prediction of quantitative and qualitative ovarian response in assisted reproductive technologies (ART), although its role still has not been established. Thus, before proposing AMH measurement as ovarian reserve testing, it should be defined what is the aim of ovarian reserve testing.In conclusion age is the most important prognostic factors regarding fertility, in naturally and even with all of ART procedures. We recommend avoidance of delay in child bearing among high-educated females and increased knowledge about age-related decline fertility and it seems ovarian reserve tests are useful as prognostic tools but poor predictors of ART outcomes.