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Hot flashes. Night sweats. Irregular menstrual periods. Mood swings. Hormonal chaos. Perimenopause brings about a lot of changes in a woman’s daily life.
So it’s only natural for your mind to race with questions about what this all means for your fertility. What are the chances of getting pregnant during perimenopause? How can you tell if you are pregnant during perimenopause?
Let’s get straight to it. The odds of getting pregnant while perimenopausal do drop. But it is still possible to get pregnant during this time. From ages 40 to 44, natural pregnancy rates hover around 10%. And from ages 45 to 49, natural pregnancy rates are closer to 2-3%.
Of course, there’s always much more beyond the numbers. So keep reading to learn all the must-knows about perimenopausal pregnancy.
What is perimenopause?
You’ve no doubt heard of menopause or a woman’s “change of life.”
When you reach menopause, you no longer menstruate. This means your reproductive years officially come to a close. But menopause doesn’t happen overnight. It’s a gradual process that takes place over the course of several years.
This transition period of hormonal and physical changes is known as perimenopause. (Quick Latin lesson: peri means around. So perimenopause means you are “around” or “approaching” menopause).
For many women, perimenopause begins around their mid-40s and lasts for up to 10 years. For example, you could be in perimenopause from age 45 to 55. But the exact start time and length of perimenopause varies from woman to woman.
One of your first perimenopause clues is having irregular menstrual cycles. And once you haven’t had a period for 12 months, you are considered to be in menopause.
Because this period varies so much by individual, it hasn’t been well-defined in sexual and reproductive healthcare. Sadly, this can cause confusion for women who still have hopes of conceiving as they age. Let’s clear up one of these major question marks next.
Can a perimenopausal woman get pregnant?
As mentioned, a perimenopause pregnancy is possible.
But it’s also more challenging to get and stay pregnant. Curious why this is so?
Here’s the short answer:
Your hormones are out of balance, and the amount of healthy eggs you have left has decreased a lot. Both of these greatly impact your ability to conceive.
Know more: What Are My Chances of Getting Pregnant By Age? Check Out Our Chart
Here’s the long answer:
- The amount of estrogen you have circulating in your body decreases.
- These lower estrogen levels cause your cycles to become irregular.
- Low levels of estradiol also affect your luteinizing hormone’s ability to surge.
- Without an adequate LH peak, you may experience more anovulatory cycles.
- These are cycles where no egg is released.
- When your body doesn’t ovulate regularly, it goes into overdrive to try to grow your follicles. This causes you to have increased follicle-stimulating hormone (FSH) and luteinizing hormone (LH) production.
- If you do happen to ovulate, the egg quality may be poor. This can make it harder for the egg to become fertilized and for the embryo to implant.
- A lower egg supply also leads to a decrease in Anti-Müllerian hormone (AMH). This throws off your hormonal balance even more.
Despite all these changes though, pregnancy can still happen. And there’s plenty of research and successfully pregnant women to prove it!
Since 2016, live birth rates for women between the ages of 40 to 44 have been on the rise. For this age group, the birth rate has actually been steadily increasing since 1985.
And for all women under 50, live birth rates have been generally trending upward since 1997.
This is hopeful news for women nearing menopause who still want to try for a baby. But there are some factors to be aware of that can affect your success rates. More on these next!
What affects your chances of getting pregnant in perimenopause?
There are quite a few factors that affect your ability to get pregnant during perimenopause. These include age, how far into perimenopause you are, and any health conditions you have. Using (or not using) ART affects your chances as well.
Learn more about each factor below:
Age
As we’ve discussed, younger women with no known health or fertility issues have an easier time getting pregnant than older women. The main reason for this has to do with a woman’s ovarian reserve declining with age.
Stage of perimenopause
How far into perimenopause you are matters too. During early perimenopause, you may have irregular periods and cycle lengths may vary by 7 days or more. But your chances of conception at this time are higher than they are as you get closer to menopause.
When you are in late perimenopause, your cycles become even more regular. And you could go up to 2 months or longer without having a period. If attempting pregnancy naturally, you have way fewer opportunities since you have to wait so long before you ovulate again.
Certain medical conditions
There’s a slew of medical conditions that can make getting pregnant a challenge. Some of these are fibroids, endometriosis, and hormonal imbalances.
One surprising outlier is PCOS. For some reason, women with PCOS seem to experience a slower decrease in fertility.
One study found that aging PCOS patients had sustained fertility outcomes when compared to aging women with regular menstrual cycles. Another study reported similar findings. For non-PCOS patients, fertility treatment outcomes declined more quickly than they did for PCOS patients.
Natural cycles vs. ART cycles
Fertility treatments (or lack thereof) affect your chances of pregnancy in perimenopause too.
Here’s what the odds of pregnancy look like in a natural cycle:
At age 40 (with no known fertility issues), your chance of getting pregnant is 5% per cycle. This means out of one hundred 40-year-old women TTC, only 5 of them would get pregnant naturally in a given cycle. In comparison, natural pregnancy rates for a 30-year-old are 20% per cycle.
Of course, these are only statistics to give you a general idea. But overall, you can see that in natural conception cycles, pregnancy rates drop off quite a bit from age 30 to 40.
Here’s what the odds of pregnancy look like with IVF:
One study of IVF patients over 40 found that pregnancy rates were 16.9% and live birth rates were 13.7%.
Keep in mind that in vitro fertilization is only one form of assisted reproduction. There are other less invasive fertility treatments available as well. These can include medications and intrauterine insemination (IUI). But IVF may be the most effective treatment method for women in perimenopause.
Besides fertility treatments, we know many of these factors are outside your control. But there are other factors within your control that can boost your fertility during perimenopause. Keep reading to see what you can do.
Are there ways to increase your chance of getting pregnant during perimenopause?
Yes, there are a few things you can try!
Here’s what we suggest:
- Take steps to improve your egg quality. This can include steps like consuming a healthy diet and managing your stress.
- Track your hormones each menstrual cycle to get a sense of your fluctuations. The Inito fertility monitor helps you track LH, estrogen, PdG, and FSH on a single test strip. This will help you see if you are actually ovulating or not.
- Talk to a fertility specialist or healthcare professional to learn more about ART options.
- Fertility treatments like IVF may improve your chances of pregnancy.
Consider using donor eggs if your egg quality is not adequate for a healthy pregnancy.
Let’s say you do get pregnant while in perimenopause. How exciting! But perhaps you have concerns about the risks you may face once pregnant. Let’s talk about this next.
Is it risky to conceive during perimenopause?
Yes, pregnancy can be riskier when you are in perimenopause. Let’s break down where the increased risk comes into play.
As maternal age increases, there’s an increased chance of:
- Chromosomal abnormalities
- Miscarriage or stillbirth
- Maternal co-morbidities like hypertension or gestational diabetes
- Preterm birth (delivering before 37 weeks) (One study found that the rate of preterm birth was 30% higher for mothers 35 or older.)
- Lower fetal birth weight
- Having to deliver via a C-section
We know this may sound scary if you’re already pregnant or trying to conceive during perimenopause. But keep in mind that there are risks with any pregnancy no matter the age.
And with careful monitoring by your healthcare provider, you can improve your chances of having a safe and successful pregnancy.
Now, let’s say you’ve been having out-of-the-ordinary symptoms lately. And you’re not 100% sure if they’re from perimenopause or if you’re pregnant.
Because let’s face it, perimenopause and pregnancy can both make you feel like your body is out of whack. In the next section, we’ll go over how to tell the difference.
How do I know if it's perimenopause or pregnancy?
One of the telltale signs of perimenopause is having irregular periods or missed periods. Well if you’re trying to conceive, this is pretty confusing, right?
Unfortunately, many pregnancy symptoms and perimenopause symptoms do overlap.
But here’s a quick glimpse at how you may be able to tell between the two:
Perimenopause | Both | Pregnancy |
Hot flashes Vaginal dryness Sleep disturbances | Missed period Mood swings Constipation Increased urination Fatigue | Nausea Increased vaginal discharge Cramping Implantation bleeding Breast fullness or tenderness Food aversions |
As you can see, trying to self-diagnose based on symptoms will prove to be a challenge. When it comes down to it, a pregnancy test is the only way to confirm.
Already took a pregnancy test and confused about the result? Check in with your healthcare professional. They can order additional tests if necessary to see if you are pregnant or not.
And if you’re looking for a way to better track your symptoms, consider using the free app that pairs with the Inito fertility monitor. Inito allows you to track 4 fertility hormones: LH, estrogen, PdG, and FSH on a single test strip. With all this helpful data, you can see whether you’re ovulating or not, and how your symptoms correlate with your hormone levels. Think of it as a visual way to make more sense of all the changes going on with your body.
Takeaways
- Perimenopause is the time when you are transitioning into menopause. Menopause is marked by when a woman’s periods stop and her ovaries no longer release eggs.
- The average age for perimenopause to begin is mid-40s. But the exact timing depends on each person’s unique menstrual periods.
- During perimenopause, you’ll begin to have irregular or missed periods. And you’ll also experience hormonal changes.
- It is possible to conceive during perimenopause. This includes both natural pregnancies and pregnancies aided by ART.
- Some symptoms of perimenopause are similar to early pregnancy symptoms. So the best way to tell if you are pregnant or not is to take a pregnancy test.
- If you’re TTC in perimenopause, there are ways to boost your chances. You can optimize your lifestyle to boost your egg quality. You can also look into fertility treatments like IVF or consider using donor eggs.
- Take hormone tests or use a fertility monitor like Inito to help you track changes in your fertility hormones and give you a better idea of what’s going on with your cycles.
- Certain pregnancy complications like premature birth, miscarriage, and high blood pressure are more common in perimenopausal women.
FAQs
Yes, you can. This is because ovulation may still happen without any menstrual bleeding in the weeks prior. If you think you’ve had a missed period or could be pregnant, take a pregnancy test. That will be the only way to tell for sure!
One study found that natural pregnancy rates for women ages 45 to 49 were 2-3%. But keep in mind that the chances of pregnancy depend on a lot of factors besides age. The stage of perimenopause, your overall health, and ART treatments all play a role too.
The length of time a woman spends in perimenopause varies woman to woman. But one symptom that may help tell how far into it you are is the spacing between your periods.
When you first enter perimenopause, your menstrual cycle lengths vary by a week or so. But the farther in you are, the more spread out your cycles become. When you’re in the later stages, they can be spaced out by a few months.
There is no set limit on the age a woman can get pregnant on her own. It all depends on each woman’s unique cycle and when they stop ovulating.
At the time of this article, the oldest natural pregnancy recorded was at age 59. The mother’s name was Dawn Brooke, and she gave birth in 1997.
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- Contraception During Perimenopause: Practical Guidance – PMC
- Perimenopausal Bleeding and Bleeding After Menopause | ACOG
- Births: Final data for 2017
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- Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration)
- Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles | Neonatology | JAMA
