Night sweats, hot flashes, mood, skin and body changes, spotting, irregular menstrual periods or no menstrual periods–is it menopause or perimenopause, pregnancy, or something else? When our bodies are showing signs of change or we’re having abnormal symptoms of things we can’t fully explain, we start making guesses as to what may be happening.
Perimenopausal changes can start in your late 30s and 40s, so if you’re starting to experience changes in your body, it could mean your body is preparing for menopause. But if you’re nearing or in your 40’s and wondering if you can still get pregnant, the simple answer is yes, but the chances are slim.
If you’ve already hit menopause and are wondering if you can still get pregnant, the simple answer is that it’s highly unlikely, but not impossible. All of these answers relate to fertility in women, which is very different from fertility in men. Although men can produce viable sperm into their 60s, women typically don’t have successful pregnancies past their mid-40s.
Fertility in Women as They Age
A woman is most fertile in her 20s, and as she ages her ability to reproduce declines, especially after she reaches the age of 35.
Here are some stats for fertility as women age:
- A healthy, fertile woman at the age of 30 has a 20% chance of getting pregnant every month that she tries to conceive.
- By the age of 40, a woman has less than a 5% chance of getting pregnant every month that she tries to conceive.
- By the age of 51, most women will have started menopause and will be unable to conceive or have a successful pregnancy.
All of these stats are true for natural conception, fertility treatments, as well as in vitro fertilization (IVF). Unfortunately, the media has propagated the idea that women can get pregnant any time before or after menopause with fertility treatments, but the reality is that a woman’s age affects the success rates of infertility treatments as much as it affects natural conception. As a woman ages, the quality and quantity of her eggs continually decline. A woman in her 50s could potentially still get pregnant, but the only way that could happen would be through a donor egg and in vitro fertilization, and even then the chances of conceiving are very slim.
Menopause and Fertility
Menopause is not the end of fertility. That may surprise you! The term menopause has actually been used loosely over the years to describe what’s actually known as perimenopause. The North American Menopause Society (NAMS) defines menopause as the point in time when a woman reaches 12 consecutive months without a menstrual period. The time leading up to menopause is actually called perimenopause, and women still have a slim chance of getting pregnant during this time. During this time you’ll likely notice a change in hormone levels and have symptoms such as night sweats and hot flashes. Your menstrual cycles will likely be irregular and unpredictable.
Perimenopause can last six or more years for some women. It starts with changes in your menstrual cycle and can include menopause-related symptoms. This continues until you hit the 12 consecutive months without a menstrual period. During this perimenopausal time period, there is still a chance you could conceive.
When you start your perimenopausal transition, you only have roughly 100 eggs left (vs the 1-2 million eggs you were born with). The limited number of eggs, combined with age-related uterine changes, reduce your level of fertility. Even if you’ve missed your period a few times and have a lot of menopausal symptoms, you are not protected from an unplanned pregnancy. This is why it’s highly encouraged that women continue to take precautions until their doctor can confirm that they have reached menopause and there isn’t a chance they’ll become pregnant.
Potential Risks of Pregnancy During Perimenopause
While there are always some risks involved in pregnancy, the risks are much higher during perimenopause. There is potential for a variety of complications and women who are pregnant during perimenopause are considered to be high-risk and should be monitored more closely by medical professionals.
It’s important to know that women over the age of 40 have about a 50% chance of miscarriage. If you are a woman in your perimenopausal years and you are contemplating pregnancy, it’s highly recommended that you talk with your doctor to make sure you are well informed and medically cleared of any preexisting conditions that could complicate pregnancy even more.
Health risks during pregnancy that increase after the age of 35 can include:
- Gestational diabetes
- Multiple pregnancies
- High blood pressure
- Miscarriages or stillbirths
- Placenta previa
- Cesarean births
- Premature or low birth weight
Postmenopause and In Vitro Fertilization
When you reach postmenopause, your hormone levels are no longer suitable for ovulation and natural pregnancy, and birth control isn’t necessary anymore. However, there is still a chance you could get pregnant—through in vitro fertilization (IVF).
IVF after menopause has proven to be successful in many cases. It can be done using your own eggs that you had frozen earlier in life, or by using a donor’s eggs (fresh or frozen). This process will require you to undergo hormone therapy to prepare your body for the implantation process and to carry the baby to term.
However, be aware that postmenopausal women are much more likely to experience minor to major complications of pregnancy after IVF compared to premenopausal women.
IVF after menopause isn’t an option for everyone. It depends greatly on your overall state of health and a doctor should be able to tell you whether or not it’s an option for you.
Talk to a Provider
If you are pregnant during perimenopause, hoping to be pregnant during perimenopause or after menopause, talk with a provider! By learning about your options and being aware of your medical needs and goals, you can be prepared to make the best decision. Our team at OGA can help you every step of the way and will keep you informed at all times. Find an office near you!