conceive with an ART treatment during perimenopause

Although it is well known that the beginning of menopause is associated with the cessation of ovarian function and the end of fertility, it is logical that many women wonder if pregnancy is possible during perimenopause. In this article, in addition to discussing the possibilities of pregnancy in this situation, we would like to explain what perimenopause is, as women can sometimes confuse menopause with the period that precedes it (also called premenopause).

What is premenopause?

Menopause is the time when a woman stops having her periods because her ovaries no longer produce eggs. It usually occurs between 45 and 55 years of age. It rarely occurs before age 40 and, in such cases, it is generally related to medical treatment, surgery, or illness.

When talking about premenopause, it refers to the first symptoms signaling the arrival of menopause. But it does not always happen so mathematically: some women begin to feel these symptoms years before menopause actually becomes effective.

What are the symptoms of premenopause?

In fact, three out of four women may experience premenopausal symptoms because the hormone production — estrogen and progesterone — that regulates menstruation, also begins to decrease. Here are the main physical symptoms of premenopause.

Disrupted menstrual cycles

Hormonal changes generally shorten cycles. However, some women may have heavier bleeding because they have less progesterone.

Progesterone is a hormone that regulates the uterine lining; when progesterone decreases, the uterine lining (which covers the uterine wall to sustain pregnancy if it occurs) becomes thicker and, when shed, results in more abundant menstrual bleeding.

For all these reasons, hormonal changes can lead to worsening of what is called premenstrual syndrome (headaches, breast pain and swelling, irritability).

Hot flashes

You’ve probably heard of them, as they are the most common symptom of menopause. Like the previous, they are related to hormonal changes and sometimes occur years before menopause begins.

Hot flashes are sudden and uncomfortable sensations of heat, accompanied by heavy sweating, and are much more frequent at night. They can also disrupt sleep and cause insomnia.

Vaginal dryness and decreased libido

The decrease in estrogen production causes a loss of hydration and softness of the skin and mucous membranes. Wrinkles deepen, and general skin dryness and dryness of all mucous membranes can occur, with vaginal mucosa becoming painful due to lack of lubrication during sexual intercourse. This phenomenon, combined with decreased sexual desire due to hormonal decline, leads to reduced libido in women.

Most common vaginal and urinary infections

Furthermore, when the vaginal mucosa becomes drier, the defenses of the vagina decrease as well, and the woman loses the protective barrier created by vaginal flora, making infections more frequent. Additionally, tissues lose elasticity, and urinary leaks may become more common if pelvic muscles are not exercised.

Weight gain

Before the onset of menopause, premenopause is often associated with weight gain in almost all women. Hormones no longer protect us against fat gain, and if we continue consuming the same calories without increasing physical activity, our bodies tend to gain weight.

Can you get pregnant during premenopause?

Fertility decreases with age, but it is possible to conceive during premenopause because the ovary continues to release eggs. As long as you haven't had a period for twelve consecutive months, unplanned pregnancy is possible if precautions are not taken.

However, it must be kept in mind that the quality of eggs and sperm decreases with age, so the likelihood of spontaneous pregnancy after forty is much lower than at twenty. During premenopause, some experts mention a spontaneous pregnancy rate of less than 2% (and many of these pregnancies will end in miscarriage due to the poor egg quality associated with age), so if you are in premenopause and wish to become pregnant, we recommend consulting fertility specialists at NatuVitro.

Indeed, thanks to advances in assisted reproductive techniques, there are several options that can help increase your chances of pregnancy during premenopause. At NatuVitro, we offer multiple tailored treatments for each case to assist you, along with health advice available on our blog to boost your chances.

If you have transitioned from premenopause to menopause, meaning the absence of periods, but wish to have children, it is essential to consider egg donation.

Does pregnancy during premenopause present risks?

A few weeks ago, we wrote an article in which we discussed the risks associated with pregnancy after age 40, including increased rates of miscarriage, prematurity, or complications during pregnancy and childbirth (such as gestational diabetes, gestational hypertension, and others). Therefore, pregnancies in women over this age should be monitored more closely by obstetricians.

A higher risk does not necessarily mean that women who become pregnant during premenopause will experience more complications. Many women can have — and have had — children at this age without problems, but it is wise to take precautions and prepare the woman’s body to be as ready as possible to welcome her baby.