We will start by saying, Yes, menopausal women can get pregnant.
Menopause is the complete absence of ovulation in women after a certain age. We know that women carry a certain amount of eggs in their ovaries. After hitting puberty, due to hormonal fluctuation in the body, they start to ovulate. During ovulation, one egg matures fully and breaks free from the ovaries; travelling through the fallopian tube, it may get fertilized by a sperm and establish a pregnancy. Otherwise, the egg will reabsorb into the body through uterine walls and menstruation.
The absence of ovulation means the women don’t release mature eggs monthly. If a woman doesn’t release eggs for fertilization, she can’t become pregnant, at least not naturally. So, is it impossible for menopausal women to get pregnant? No, it’s possible for menopausal women to get pregnant, but it’ll require fertility assistance. Let’s understand how.
But, let us first understand how menopause occurs and its different stages.
Menopause and different stages of Menopause
Menopause is the stage of women’s biological cycle at which they stop ovulating. Generally, the menopausal stage starts after the age of 40 or 50, but it can start as early as in the 30s. However, menopause does not occur abruptly. There are three stages of menopause; premenopause, perimenopause, menopause or postmenopause.
Premenopause and Perimenopause
Although many women in their 30s experience irregularities in their menstrual cycle, they are not considered menopausal until they miss periods for 12 or more months, marking the end of menstruation. Irregularities in the menstrual cycle, hot flashes, night sweats, etc., are symptoms of perimenopause. Perimenopause is the transition stage; during this time, your ovaries produce fewer estrogens and progesterones to regulate FSH and LH.
Perimenopausal women can get pregnant as they still ovulate, though their fertility might be low. This stage can last for 7-14 years until menopause.
The average age of menopause is 50, and many women encounter between the ages of 40-55. During menopause, there won’t be irregular periods; instead, your menstrual cycle will entirely halt. If you experience that your periods stop but then start again after a long time, then you haven’t reached menopause yet; it’s still the perimenopausal phase.
During menopause, your estrogen and progesterone level remain very low, insufficient for ovulation, and you can no longer become pregnant.
After menopause, women enter the postmenopausal phase, where they cannot conceive. Postmenopausal women experience low sex drive, decreased sexual arousal, genitourinary menopause syndrome, SUI, etc. And they’re also vulnerable to health complications, namely osteoporosis, cardiovascular diseases, weight gain, and more.
Fertility Treatments for menopausal women
Nowadays, many women postpone pregnancy to a later age for personal or professional reasons. Because of reduced fertility, conceiving at an older age is not easy for women. Notably, 2 in 4 women in their 20s can get pregnant in any given menstrual cycle, 1 in 4 in their 30s, and only 1 in 10 perimenopausal women in their 40s can get pregnant per cycle.
The reduced fertility in women above 30 is the consequence of poor egg quality, diminished ovarian reserve, atrophic uterus, ovulation dysfunction, etc. however, perimenopausal women can still conceive, even naturally or with fertility help. And thanks to advanced ART technology, even menopausal or postmenopausal women can become mothers.
For perimenopausal women
If perimenopausal women struggle with infertility for any reason, treatment, such as ovarian stimulation, IUI, IVF, etc., can help achieve pregnancy. Surgeries like hysteroscopy and laparoscopy can stimulate and regulate ovulation in perimenopausal women, even at a later age.
In perimenopausal women, diminished ovulation is triggered for stimulation to produce multiple eggs for fertilization for natural or artificial conception (IUI and IVF).
IVF treatment for menopausal women
In vitro fertilization is the most suitable treatment for menopausal women to achieve pregnancy, considering their uterus is healthy enough to bear a child. Since, after menopause, women can’t produce/release eggs for fertilization, they can opt for donor eggs or use their previously frozen eggs.
Evidently, many menopausal and postmenopausal women have become mothers owing to IVF. However, menopausal women require more fertility and prenatal care to sustain pregnancy successfully than premenopausal or perimenopausal women. A menopausal woman can get IVF treatment or not; it depends on her ability to sustain or bear pregnancy, decided by her endometrial and overall health. The older the woman, the lower her ability to bear a child. Health is another concern for menopausal women while considering pregnancy.
Menopausal women also require hormonal therapy of estrogen and progesterone, also known as uterine rejuvenation, to prepare their bodies for pregnancy. The procedure of IVF treatment for women after menopause is similar to standard IVF with donor eggs but with more precautions and care.
To lower the risk of early miscarriage and genetic malformation in infants born from menopausal mothers, PGS and PGD are suggested for embryo evaluation before implantation.
Some things to keep in check for menopausal women who wants to conceive
- Menopausal women trying for conception naturally or artificially must ensure their health.
- Maintaining a healthy weight and following a healthy diet enriched with essential micro and macro nutrients like calcium, Vit D, folic acids, etc., is crucial for the health of mother and baby. Taking supplementation is also advisable.
- You can also indulge in light exercises and pregnancy yoga.
- Make sure your endometrium is thick enough to allow implantation and carry a pregnancy. If not, you can opt for a gestational carrier for your baby.
Risk and Complications of menopausal pregnancy
The complication of pregnancy for menopausal women are higher than perimenopausal women, but it also depends on their overall health. And perimenopausal women have higher risks than women younger than 35. It is because older women carry pre-existing medical conditions that can complicate the pregnancy period. The risks include:
- Gestational Diabetes
- Multiple pregnancies
- Caesarean delivery
- Miscarriage or stillbirth
- Childbirth with down syndrome
- Premature or low birth weight
However, some complicating factors can be reduced with genetic screening, such as PGS and PGD.
IVF for menopausal women at Risaa IVF
Menopausal pregnancy is not unattainable, but it sure requires fertility assistance with hormone therapy and IVF. Without IVF or fertility treatment, it is almost impossible for women above the childbearing age to achieve pregnancy. That said, it’s not easy and risk-free. Only an expert fertility specialist with vast experience in reproductive and fertility help can help you conceive without many complications.
Dr. Rita Bakhi, the senior doctor at Risaa IVF, has 30+ experience in fertility and ART treatments. She does not play with the patient’s health and only suggests what’s best for them. Many older couples have joined parenthood under Dr. Bakshi’s IVF treatment plans. So, if you’re considering late pregnancy, make sure you get the best fertility help at the best IVF centre in India.
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