Menopause marks the end of your fertility, but the situation in the years leading up to it is less clear. If you are approaching 40 and are noticing signs of hormonal changes, you might be in perimenopause, and your chances of having a baby may be shrinking.
IVF (in vitro fertilization) is often advertised as a viable option for individuals struggling with potential fertility issues, regardless of the reason. So, can you get pregnant during perimenopause with IVF? Find out how IVF might help and who the right candidates are in this helpful guide.
Can you do IVF during perimenopause?
Yes, you can do IVF in perimenopause. Even though hormone levels are changing and your fertility is declining, pregnancy is still possible, especially with medical help.
Still, IVF during perimenopause can entail additional challenges caused by:
Lower ovarian reserve
Potentially compromised egg quality
Less predictable hormone levels
It may be harder for your body to respond to standard IVF stimulation protocols, so adjustments may be necessary. It helps to choose a fertility clinic specializing in fertility treatments for women your age.
Source: Sarah Chai
How does perimenopause affect your fertility?
By the time you reach perimenopause, the number of eggs left (your ovarian reserve) is significantly lower than before. The eggs that remain are more likely to have genetic issues, which can make it harder to conceive or increase the risk of miscarriage.
Due to hormonal changes and irregular menstrual cycles, it may be difficult to know whether and when you’re fertile in a given month.
Several reproductive hormones are affected during perimenopause:
Estrogen: It may swing up and down unpredictably, causing symptoms like hot flashes and mood changes, and making your periods irregular and anovulatory (no eggs are released).
Progesterone: This hormone usually rises after ovulation to prepare your uterus for pregnancy. If you’re not ovulating regularly, your body doesn’t produce it as much, which can shorten the second half of your cycle and affect implantation.
Luteinizing hormone (LH): This hormone triggers ovulation, but if it’s increased in perimenopause, it may contribute towards irregular cycles.
However, there’s no need to be discouraged because many women get pregnant during perimenopause:
How to improve your IVF success chances in perimenopause
By the time you’re 40, the chance of conceiving naturally is only 10–20% per cycle, but IVF can increase those chances:
Age group | IVF success rate |
|---|---|
Under 35 | 47.2% |
35–37 | 34.6% |
38–40 | 22.1% |
Over 40 | 7.2% |
There are also steps you can take to increase your overall chances of conception and IVF success during perimenopause, such as:
Tracking ovulation: Ovulation predictor kits, basal body temperature charts, or hormone blood tests can help identify when or if you’re ovulating.
Focusing on a healthy lifestyle: To help your body respond better to treatment and support a healthy pregnancy, you should:
Eat a balanced diet rich in whole grains, lean protein, fruit, and vegetables.
Exercise regularly, but gently (yoga, walking, or swimming).
Maintain a healthy weight, as being overweight and underweight can affect hormone balance.
Reduce stress through therapy, meditation, or different relaxation techniques
Avoid smoking and alcohol as they can impact fertility.
Taking supplements: Folic acid supports fetal development and reduces the risk of neural tube defects. Prenatal supplements with vitamin D, iron, and calcium are also advisable, depending on your individual health status and diet.
Managing existing health conditions: Chronic conditions like high blood pressure or diabetes can affect your ability to conceive and increase pregnancy risk.
Source: Pavel Danilyuk
IVF options during perimenopause
If you’ve been trying to get pregnant for six or more months without success, consider consulting a fertility specialist. They will run blood tests and perform ultrasounds to determine the most appropriate next steps.
Four common IVF-related options may be available:
1. Mature oocyte cryopreservation (egg freezing)
If you’re still ovulating and your ovarian reserve hasn’t declined significantly, you may choose to freeze your eggs. This option is best suited for women in early perimenopause who aren’t ready to conceive yet but want to preserve their fertility.
Here is how the process goes:
Ovarian stimulation to produce multiple eggs
Egg retrieval
Egg freezing and storing
The success of egg freezing depends on the quality and quantity of eggs retrieved, so it’s typically best to do it as early as possible.
2. Frozen embryo transfer (FET)
If you’re ready to undergo IVF with your partner or sperm donor, you may choose to create embryos and freeze them. In this case, your eggs are fertilized shortly after retrieval, and the embryos are stored until your body is ready for implantation.
FET allows more flexibility and better control over the timing of pregnancy. It also gives your doctor time to optimize your uterine environment for implantation, which is particularly important during perimenopause.
Additionally, using frozen embryos increases the chances of IVF success compared to using frozen eggs.
Source: Helena Lopes
3. Perimenopause and IVF with donor egg
If your egg quality or ovarian reserve is too low for IVF to be successful, donor eggs are a highly effective alternative. Egg donors are typically younger and have high-quality eggs, which significantly increases the chance of a healthy pregnancy, even in your 40s or early 50s.
Donor eggs can be from someone you know (such as a relative, if maintaining a biological connection is important to you) or obtained through an anonymous donor program. These eggs are fertilized and transferred to your uterus after careful hormonal preparation to ensure your body is ready to support the pregnancy.
4. Standard IVF with hormone monitoring
If you are perimenopausal, you can still do IVF with your own eggs, but close hormone monitoring is critical. Your doctor will particularly observe estradiol (E2), FSH, LH, anti-Müllerian hormone (AMH), and progesterone to determine the best timing and approach. Ovarian stimulation protocols will be tailored based on your age, hormone levels, and ovarian reserve.
It’s crucial to start IVF when hormone levels are at baseline early in the cycle. Elevated levels and wrong timing can reduce egg quality, disrupt uterine receptivity, and increase the risk of failed implantation and miscarriage.
Risks of IVF in perimenopause
Women over 40 face a 40% chance of miscarriage. Pregnancy during perimenopause is also more likely to be classified as high risk due to age-related changes in reproductive and general health. Interventions, such as C-sections, are also more common.
Both you and your baby may face certain risks, as presented in the following table:
Risks to the mother | Risks to the baby |
|---|---|
|
|
How genetic testing supports IVF success during perimenopause
Before you begin IVF, you should consider carrier screening to see whether you or your partner carries genetic conditions that could be passed on to your child, such as:
Source: Tatiana Syrikova
During the IVF process, preimplantation genetic testing can significantly improve the chances of a healthy pregnancy, especially during perimenopause when egg quality declines and the risk of chromosomal abnormalities increases.
When you are pregnant, there are additional prenatal genetic tests to confirm that everything is progressing correctly.
These tests can help you and your fertility team:
Improve the chance of successful implantation
Lower the risk of miscarriage
Prepare for potential challenges on time
Here is an overview of genetic tests available:
Preimplantation genetic testing | Prenatal genetic testing |
|---|---|
|
Nucleus IVF+: Maximize your IVF chances, minimize the unknowns
During perimenopause, IVF can feel even more overwhelming. You may be balancing unpredictable hormone changes, weighing the possibility of using donor eggs, worrying about miscarriage and genetic risks, and juggling the logistics of the process.
Nucleus IVF+ can make this journey easier, so you can focus on your future family, not the stress.
Nucleus IVF+ is an all-inclusive IVF package built for genetic optimization while ensuring human and compassionate care, invaluable insights, and guidance at every stage of the process. You get:
24/7 access to expert genetic counselors and fertility specialists
Carrier screening for over [NUM_CONDITIONS_SCREENED] genetic conditions, hundreds more than standard tests, to better understand the common and rare disease risks you may pass on to your child
Access to top partner clinics and donor networks, ensuring world-class support tailored to perimenopausal mothers
Embryo analysis beyond basic viability, estimating each embryo’s health potential, well-being traits, and long-term outlook
Care that continues after birth, helping you protect your child’s health from day one while giving you deeper insights into your own
Nucleus can help you find the suitable clinic for all kinds of testing, and provide you with parent-friendly insights that you can leverage to make informed decisions along the way.
You actively participate in your journey to parenthood; Nucleus only guides the way.
Book a call with the Nucleus team today to start your personalized fertility journey.
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Featured image source: Daniel Reche
