Can you still get pregnant during the perimenopause? An expert explains all

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If you want to get pregnant during the perimenopause, priming yourself is vital, says fertility expert Dr Larisa Corda.

What is the perimenopause?

Perimenopause, or menopause transition, is the time when a woman’s body starts to transition into the menopause and her periods become irregular, as well as her ovulation.

What are perimenopause symptoms?

She may start experiencing common symptoms such as hot flashes, changes in mood and libido, as well as vaginal dryness and more painful intercourse, as well as anxiety and depression.

For the majority of women these symptoms last for around 2 years but in some, they can be as long as 10 years. Scientifically, what’s driving this is the fact that the ovaries are losing their reproductive function, with dwindling numbers of eggs and also sex hormones, that’s oestrogen and progesterone.

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As a result, the brain overcompensates in an attempt to get the ovaries to produce more hormones and ends up secreting more follicle stimulating hormone, or FSH, that can then encourage more than one follicle to grow and release an egg, which is also why the chance of twins increases with age.

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The average age of the menopause is between 48 and 52 in the UK , and for most women the perimenopause starts in their 40s. Sadly, though, some women can end up undergoing early ovarian ageing much sooner, either because of a medical condition that affects them, or because they may have had surgery to remove their ovaries. Or sometimes it happens totally unpredictably, though your risk is slightly higher if you have a relative affected by it.

What is the perimenopause pregnancy rate?

The chance of conceiving naturally around the perimenopause is very low, usually no more than around 2%, and even techniques such as IVF are limited due to the low number of eggs available and their significantly lower quality compared to younger eggs. In addition, the risk of miscarriage becomes much higher, reaching 50% in women aged 45, as well as the risk of certain congenital abnormalities.

Perimenopause and your fertility: the facts

Then, there is the additional risk of being pregnant at an older age to take into account. Being older may mean that you’ve accrued medical conditions such as high blood pressure, diabetes, fibroids or cervical disease, that could render any pregnancy more complicated. Risks such as pre eclampsia, preterm labour, placental problems and growth restriction of the baby can all be more common.

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However, looking after yourself and ensuring that your body is as capable as possible of supporting a healthy pregnancy, as well as producing the best possible quality of eggs, is really important, as both can improve the chance of conception, and lead to a healthier baby. There is no doubt that using donor eggs at this stage leads to the best chance of success of up to around 40%. However, for many women, this is not an easy decision and can be complicated if she already has biological children of her own.

How can I prime myself for pregnancy?

Priming yourself is vital and the rules of The Conception Plan are just as applicable here as they are to a younger woman.

They include eating good, clean nutritious and organic food where possible, that has not been affected by chemicals or pesticides and is predominantly plant based.

Exercise is vital for improving blood flow to the main reproductive organs as well as keeping your body weight in the normal range and reducing the chance of miscarriage.

Minimising toxic exposure by cutting out smoking and alcohol is important for you and the baby, as well as making a decision to use products whose composition is predominantly natural, so as to reduce the risk of disrupting any hormone signalling in the body.

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Sleep is important for improving immunity and getting rid of excess hormones, whereas regular sex throughout your cycle can help improve the quality of sperm as well as the internal womb conditions for the baby. Stress management is often underestimated but is important when it comes to keeping the sex hormones in balance, along with many other possible influences we don’t fully understand yet.

Should I freeze my eggs?

Aside from lifestyle interventions, it’s important to consider fertility preservation sooner rather than later if you think you may be deferred in being able to start a family, whether it’s through lack of a suitable partner or due to career progression. Sometimes the desire to have a child is aroused later on in women and sometimes it occurs because of a new relationship, but where possible, preservation via egg or embryo freezing up to the age of 40 is something that will give the best chance of success later on.

What has recently been hailed as a new menopause cure involves the surgical extraction of ovarian tissue, currently being done for women with severe conditions that would tip them into an early menopause, such as cancer.

The tissue is frozen and then re-implanted into the woman, allowing a woman the chance to have biological children later in life and avoid the debilitating symptoms of the menopause for what could be another decade or two. However, though healthy children have been born around the world this way, it isn’t clear whether this is something that should become a fertility preserving measure in women who are not at risk of an early menopause.

The key is to consider your fertility from earlier in life and to discuss it with your doctor, to help you make the best decisions.