Once a woman reaches post-menopause, ovulation no longer takes place and birth control will not be necessary anymore. There were some cases where women still got pregnant during perimenopause and menopause. However, it is highly unlikely for someone to fall pregnant during postmenopause. The reason is that ovulation will not take place, and this is crucial for fertilisation to happen. Falling pregnant during perimenopause and menopause increases the risks of that pregnancy. It is important to speak to a healthcare professional first before falling pregnant during menopause, to ensure close monitoring for the mother and baby.
During menopause oestrogen and progesterone levels decrease since the ovaries no longer produce these hormones.
Why Is Ovulation Important For Pregnancy?
A normal menstrual cycle each month is important so that ovulation can take place. This happens when ovaries release an “egg” to be fertilised by a sperm cell. When an egg is released from the ovaries. The egg will travel through the fallopian tubes while the uterus will prepare the environment for the implantation of a fertilised egg.
Once the released egg is fertilised with a sperm cell it is called an embryo. Sometimes more than one egg is released and fertilised at a time, this is when a woman is pregnant with more than one baby at a time. Ovulation does not happen for every woman every month.
Each body is different. Some conditions can influence ovulation, such as endometriosis. When ovulation takes place and there is no sperm cell to fertilise the egg, the egg will be reabsorbed by the body and excreted by the blood during the following menstrual cycle. Women are most fertile 7 days before ovulation and two days after ovulation, but particularly the day before and on ovulation. These days before the egg is released is called the “fertile window”.
What Happens To Ovulation During Menopause?
Ovarian-produced estrogen plays a vital role in preserving the reproductive system. In perimenopause, the ovaries' production of estrogen and progesterone declines, impacting the ovulation process. Ovulation commonly ceases because estrogen and progesterone levels tend to fluctuate during perimenopause. Consequently, a woman's likelihood of becoming pregnant during perimenopause is affected.
Fertility In Women As They Age
Women are most fertile in their 20’s. As they age their chances for becoming pregnant also decrease, especially after they have reached the age of 35. After the age of 35, there is an increase in pregnancy risks. Women over the age of 40 only have a 5% chance of falling pregnant each month. Most women by the age of 51 will have reached menopause and will be unable to fall pregnant. A woman’s age affects the success rate of infertility treatment as well.
Menopause And Infertility
Menopause does not mean the end of fertility. With technology and medical devices changing at a rapid pace, it is possible to increase the chances of falling pregnant during menopause. When a woman starts with perimenopause transition, they normally roughly only have 100 eggs left. When a girl is born, she is born with 1-2 million eggs. Due to this limited number of eggs and age-related uterine changes, it can reduce the level of fertility. Even though the level of fertility decreases during perimenopause there is still a chance of falling pregnant. Women are advised to take precautions until their healthcare providers can confirm they have reached the menopause stage.
Risks Of Pregnancy During Perimenopause
There are always risks during pregnancy, but they become much higher during perimenopause. Women who are pregnant during perimenopause should be monitored closely by healthcare professionals. Women over the age of 40 have a 50% chance of getting a miscarriage. If a woman wants to become pregnant during her perimenopause phase she needs to consult a doctor to make sure she makes a well-informed decision.
Health Risks During Pregnancy (After The Age Of 35)
- Gestational diabetes- This is when a woman gets diabetes during pregnancy due to hormone therapy such as fertility therapy.
- Multiple pregnancies – Some fertility therapy will increase the chance of falling pregnant with more than one baby at a time.
- High blood pressure (Preeclampsia) – This should be monitored closely. Doctors can provide medication to lower blood pressure.
- Miscarriages and stillbirths – Chances for miscarriages increase during perimenopausal pregnancies.
- Placenta previa – This is when the placenta is implanted at the bottom of the cervix which means the baby will not be able to be born vaginally.
- C-section births – There are more risks involved with caesarean births than vaginal births.
- Premature or low birth weight – This will increase the time spent in the hospital. Premature babies need to be monitored closely in the hospital.
- Increased risk of having a child with Down syndrome.
Post-Menopause And In-Vitro Fertilisation (IVF)
Once a woman enters the post-menopausal stage, ovulation ceases, making natural pregnancy unattainable. In such cases, in-vitro fertilization (IVF) becomes a potential solution. Seeking guidance from a healthcare professional is essential when considering IVF post-menopause. To facilitate this process, women should explore the option of freezing their eggs before entering menopause.
Successful IVF typically involves hormone therapy, including estrogen and progesterone, to prepare the uterine environment for the implantation of a fertilized egg. It's important to understand that the risks associated with pregnancy significantly increase after menopause, and IVF may not be suitable for all individuals. Therefore, it is crucial to have a discussion about this option with healthcare professionals.
It's worth noting that the risk of Down syndrome rises with a woman's age. Older mothers, especially those conceiving after the age of 35, have a higher probability of having a baby affected by Down syndrome. This increased risk is attributed to the greater likelihood of improper chromosome division in older eggs.