Is It Possible to Get Pregnant After Menopause?

We've all heard anecdotal stories about people getting pregnant and carrying babies to term in their 40s, 50s, or even later. But is pregnancy a possibility after someone goes through menopause—the time of life when menstrual periods permanently stop?¹

Pregnancy after menopause is rare, but it may be possible in special circumstances. In fact, a 2020 case report found that a 54-year-old woman in Iran gave birth after going through menopause at 47.² In recent years, fertility treatments have also made it possible for some people to get pregnant without having a menstrual cycle.³

Whether you're curious about the chance of pregnancy at 37 or 55, here's what you should know about the likelihood and possible risks of getting pregnant after menopause.

What Is Menopause?

Menopause is a normal part of healthy aging. Sometimes called the "change of life," menopause refers to the point in time when someone has not had a period for 12 months in a row.⁴ Most women reach menopause between the ages of 45 and 55, although it may happen earlier or later in some cases.¹

Perimenopause, also called the menopausal transition, often starts during someone's 30s or 40s and lasts for five years or more.¹,⁵ Many people going through perimenopause first notice changes to their period, such as lighter bleeding or irregular cycles. Over time, they begin to miss their period more often as their ovaries stop releasing eggs each month (ovulation).¹

During perimenopause, the body's levels of hormones like estrogen and progesterone start to shift dramatically.⁴ These hormonal changes can lead to a number of symptoms, including:¹

• Irregular vaginal bleeding
• Hot flashes
• Excessive sweating, especially at night
• Insomnia
• Rapid heart rate
• Sexual side effects, such as lower libido and vaginal dryness
• Headaches
• Urine leakage due to changes to the pelvic floor
• Mood swings, depression, and anxiety
• Joint pain
• Brain fog
• Problems with memory
• Urinary tract infections (UTIs)

Pregnancy During Perimenopause

Fertility declines with age. As you enter your mid-30s, your ovarian reserve—the number and quality of your remaining eggs—starts to decrease. About 25% of couples in their 20s and 30s will conceive in a given cycle. Meanwhile, only 10% of women will get pregnant in a given month by the time they turn 40.⁶

By the time you notice the first symptoms of perimenopause, such as a missed period, your ovarian reserve has most likely already declined significantly. Changes in estrogen levels, irregular periods, and decreased sex drive may also make it harder to conceive during perimenopause.⁷ For most women, the chance of getting pregnant starts to decline at age 30, followed by another dip in their late 30s and a significant, rapid decline when they reach their late 40s.⁶

Still, if you're going through menopause and not planning to get pregnant, you should use contraception until it's been a year since your last period. While it's not likely that you'll have an unplanned pregnancy during perimenopause, it's not impossible.⁴

However, if you're noticing symptoms of menopause and want to try to have a baby, talk to your healthcare provider about fertility testing. They can test your levels of fertility-related hormones, such as Anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH), to help you know more about your likelihood of getting pregnant within the next few years.⁷

What Is Postmenopause?

Postmenopause refers to the time in someone's life after they have permanently stopped having menstrual periods.⁸ While it varies widely, the average age at which someone reaches menopause and enters the postmenopausal period is 51.⁵

Many people notice changes in their weight, body composition (such as the way fat is distributed on their body), energy levels, mood, and overall health and well-being after menopause.⁴ There are also several potential long-term complications associated with postmenopause, including:⁵

• Abnormal vaginal bleeding
• Bone loss
• Osteoporosis (a condition involving weak, brittle bones)
• High blood pressure
• High cholesterol
• Increased risk of heart disease
• Increased risk of stroke

Many postmenopausal health complications are linked to lower estrogen levels, while others are related to the aging process. These symptoms can often be addressed with lifestyle changes, hormone therapy, supplements, and/or medication.⁸

Pregnancy During or After Menopause

Generally speaking, people don't experience spontaneous pregnancies after going through menopause.⁸

However, it may be possible to get pregnant during postmenopause using fertility treatments like in vitro fertilization (IVF). IVF is a form of assisted reproductive technology (ART) that involves combining an egg with sperm in a laboratory. After fertilization, the embryo is transferred to your uterus.⁹

After menopause, you won't be able to ovulate (release an egg from your ovary), even with assistance. Post-menopausal people who want to get pregnant through IVF typically use donor eggs from someone else. Donor eggs can be combined either with your partner's sperm or with donated sperm. If you've had eggs or embryos frozen in the past, you can also use them for IVF even if you've gone through menopause.³

Risks of Pregnancy After Menopause

The main risk of going through IVF at any age is an increased chance of a multiple pregnancy. Your fertility specialist can transfer only one embryo at a time to decrease your chance of having twins or triplets.⁹

People who get pregnant at age 35 or later also have an increased risk of:⁶

• Miscarriage
• Premature birth
• Cesarean section (C-section)^³
• Preeclampsia (high blood pressure during pregnancy)
• Having a baby with chromosomal abnormalities, such as Down syndrome

Many of these risks, such as the risk of congenital birth defects, may be lowered by undergoing IVF using donor eggs from a younger person.³ Others, like preeclampsia, can be prevented or managed with healthy lifestyle changes and consistent prenatal care.⁶

Recap

Fertility in women begins to decline in their 30s and falls sharply by age 40. If you're going through perimenopause (the transition to menopause), your chance of getting pregnant without fertility treatments is low, but not zero. Menopause, or the end of menstrual cycles, is marked by 12 months without a period and typically occurs between the ages of 45 and 55.

If you've already gone through menopause but think you want to get pregnant, talk to your healthcare provider about the possibility of IVF. And, of course, talk to your doctor right away if you think you may be pregnant, regardless of your age.

Sources:

1. MedlinePlus. Menopause.
2. Mirsafi R, Attarha M. Postmenopausal pregnancy: a case report. Iran J Nurs Midwifery Res. 2020;25(3):260-262. doi:10.4103/ijnmr.IJNMR_94_19
3. Cutas D, Smajdor A. Postmenopausal motherhood reloaded: advanced age and in vitro derived gametes. Hypatia. 2015;30(2):386-402. doi:10.1111/hypa.12151
4. National Institute on Aging. What is menopause?
5. The American College of Obstetricians and Gynecologists. The menopause years.
6. The American College of Obstetricians and Gynecologists. Having a baby after age 35: how aging affects fertility and pregnancy.
7. Santoro N. Perimenopause: from research to practice. J Womens Health (Larchmt). 2016;25(4):332-339. doi:10.1089/jwh.2015.5556
8. Dalal PK, Agarwal M. Postmenopausal syndrome. Indian J Psychiatry. 2015;57(Suppl 2):S222-S232. doi:10.4103/0019-5545.161483
9. The American College of Obstetricians and Gynecologists. Treating infertility.