Can You Get Pregnant After Menopause?

Menopause and Fertility

During your childbearing years, your female hormone levels are at their highest, and your eggs are at their healthiest, meaning pregnancy can happen more quickly and is possible every month. The menstrual cycle hormones include the luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which cause ovulation and stimulate the ovaries to produce estrogen and progesterone. Every month, estrogen and progesterone then do their job of preparing the uterus for possible fertilization. A period occurs if conception does not happen, and then the process begins anew. During this time of life, a woman is her most fertile.

Perimenopause, or the beginning of the menopause transition, generally starts in the late 30s or early 40s, with some women starting earlier or later. During this time, estrogen levels fluctuate, and menstruation, in turn, becomes inconsistent. You may skip months of periods, only to have one surprise you unexpectedly. You may also start to experience menopause symptoms, since the ovaries start to produce less estrogen and progesterone. The following are common symptoms that may begin or intensify at this time:

• Hot flashes 

• Mood changes

• Sleep problems

• Vaginal dryness

• Weight gain

Because periods become irregular, it’s challenging to track fertility windows or even determine if you’re pregnant. During perimenopause, you still have the necessary hormones for conception, if you want to become pregnant, but fertility declines naturally with age. You may want to consult a medical provider to optimize this stage of life, if you’re hoping to conceive.

Menopause officially commences once you have gone 12 consecutive months without a period. At this point, estrogen and progesterone levels are at their lowest, and periods cease, because the ovaries no longer release an egg. Because the body isn’t producing the necessary hormones for pregnancy, fertility is affected and the likelihood of pregnancy diminishes. Generally, women can not become pregnant naturally at this stage, although “miracle” stories of pregnancies in older women do show up occasionally in the news. 

Some women experience a sense of relief that pregnancy is no longer possible. However, this may feel devastating for others who desire a pregnancy. A woman’s menopausal onset and duration determine the oldest age at which a woman can become pregnant naturally, but modern technology can help achieve the dream of parenthood. A woman can become pregnant after menopause, with medical assistance to augment the lack of pregnancy hormones.

How Can a Woman Get Pregnant after Menopause?

The average age of menopause for women is 51, but most women may be unable to have a successful pregnancy starting in their late 40s, due to declining estrogen. Women are no longer able to become naturally pregnant after actual menopause has occurred. 

If a woman desires to become pregnant after menopause, she may have to use advanced scientific interventions. Assisted Reproductive Technology (ART) includes all fertility treatments used for eggs and embryos. ART involves surgically removing eggs from the ovaries and combining them with sperm, then placing them in a woman’s body or into a surrogate. Advances in ART and egg donation enable perimenopausal and menopausal women to conceive and deliver healthy babies. 

Cryopreservation, or embryo freezing, is a process that involves fertilizing eggs and storing them for later use. Eggs can be frozen in a woman’s 20s and 30s, and these eggs will be healthier to use when she’s ready to conceive. Women may choose cryopreservation and then have the embryo implanted via in vitro fertilization (IVF) to get pregnant after menopause. 

IVF uses either frozen embryos or donor eggs - the latter of which are used if a woman’s eggs have not been previously frozen, since a menopausal woman does not have viable eggs at this stage in her life. 

A woman using IVF will need to undergo hormone therapy to replace the estrogen and progesterone necessary to successfully implant the embryo in the uterus and maintain the pregnancy. In one study, IVF had a 75% favorable rate for women over 40. 

Artificial insemination is another ART for perimenopausal women that may still be ovulating; a doctor inserts sperm directly into a woman’s cervix, to ensure successful placement and implantation. 

Overall, if a woman has crossed the threshold of menopause, she can not produce the eggs to make a baby. Lacking sufficient estrogen and progesterone, the uterus will not maintain a pregnancy. However, modern technology, including hormone supplements, can assist in achieving pregnancy through donor eggs and IVF. 

Health Risks of Late Pregnancy

A woman who becomes pregnant after the age of 35 is considered to be of advanced maternal age, which means there is a higher chance of certain complications. A menopausal woman considering ART should undergo counseling and screening for high blood pressure and other health issues, before attempting to become pregnant. A healthy lifestyle and consistent prenatal care with a fertility specialist are necessary, and prenatal testing is available to rule out any chromosomal or genetic abnormalities. 

Late pregnancies can carry substantial risks for both the mother and the baby. Possible complications of pregnancies in menopause include the following: 

• Chromosomal abnormalities, including Down syndrome

• Genetic conditions 

• Gestational diabetes

• Heart problems, like gestational hypertension or spontaneous coronary artery dissection

• Premature birth, resulting in low birth weight

• Delivery complications that require a longer delivery or a cesarean delivery (c-section)

• Ectopic pregnancy: when the embryo attaches outside the uterus

• Excessive bleeding after delivery

• Potential for multiples (twins, triplets, etc.) with IVF, which may result in difficult delivery

• Preeclampsia from high blood pressure that includes organ damage and seizures

• Pregnancy loss/miscarriage

Frequent consultations with a maternal-fetal physician is important, in order to monitor the risk of any of these complications in a pregnancy later in life. 

Conclusion

Pregnancy during the menopause transition is possible, with the intervention of the appropriate ART. To conceive and successfully carry a pregnancy to term at this stage of life, estrogen and progesterone therapy are part of the process. If you’re in your menopause transition and are considering hormone therapy, schedule a consultation with one of our board-certified physicians at Winona. They have expert advice and experience that can guide you through your questions concerning menopause and fertility.