Can I have a child in menopause?

A woman can define herself in menopause on the basis of hormonal values ​​(such as high FSH, low estradiol) and after at least one year has passed without menstruation .

From that moment on the ovaries will no longer work, no more follicles will mature and there will be no more ovulation, consequently it will no longer be possible to conceive naturally.

Menopause does not happen overnight, but is preceded by a more or less long period, usually 8 to 10 years , called perimenopause .

What is perimenopause

Perimenopause is a time of transition: the ovaries start producing less estrogen and progesterone. The levels of LH and FSH begin to rise and the ovaries begin to become less sensitive to these changes.

During a woman’s childbearing age, a series of hormones are involved in ensuring that menstrual cycles occur regularly : estrogen, progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH).

All work in synergy and with certain timing so that the ovaries can release a mature oocyte every month during ovulation , an oocyte that can be fertilized by a sperm and lead to pregnancy.

Ovulation cannot occur if hormone levels are not within normal ranges.

As hormone levels fluctuate, a woman may begin to notice symptoms such as hot flashes and night sweats. Menstrual cycles irregular in length and frequency. Cycles are most frequently anovulatory.

Although fertility is progressively decreasing (remember that fertility begins to decline after the age of 36 but it is usually after the age of 42-43 that the decline is really drastic) during perimenopause it is still possible to conceive even if with a low probability . In fact, the egg quality is very poor.

During perimenopause, menstruation may stop, months go by, and it may appear again. This can happen many times and only if a full year has passed since your last period, then you can clearly state that you have entered menopause. Confirmation will come via a gynecological checkup.

For most women, menopause occurs between the ages of 45 and 55, with the average age being 50-51 . Unfortunately, women who experience early menopause are not rare .

Once menopause is reached, LH and FSH levels remain high and estrogen and progesterone levels remain low. The woman no longer ovulates and cannot conceive a child naturally.

When the woman is in menopause, pregnancy can only take place thanks to assisted fertilization.

Assisted fertilization in menopause

When the woman is in menopause she can no longer produce oocytes useful for fertilization. However, there are still two options for getting pregnant:

• use frozen eggs from the woman herself when she was younger
• use oocytes from a donor for a process of heterologous fertilization.

In order to carry on a pregnancy, the woman will have to undergo hormonal therapies to prepare the body for implantation and for the continuation of the pregnancy.

Although it is possible to carry on a pregnancy in menopause, thanks to assisted fertilization , it is important to remember that women who face a pregnancy in this phase of their life are at greater risk of more or less serious complications.

Can menopause be reversed?

At the moment no, it’s not possible, but researchers have been working on it for some years, especially along a path that uses platelet-rich plasma (autologous PRP) . PRP contains growth factors, hormones and cytokines.

Early efforts to restore activity in the ovaries of perimenopausal women indicate that restoration of ovarian activity is possible, but only temporarily. The research is still in the early stages and clinical trials are ongoing.

Health risks of menopausal pregnancy

There is too little talk about the risks of late pregnancy, risks that should never be underestimated. Doctors should always point out to couples who make the decision to become pregnant when they are biologically no longer fertile, what problems they could face.

Above all, these are risks of varying seriousness for the health of the woman and, consequently, for the child (eg preterm birth).

The health risks of pregnancy increase with age . After the age of 35, the chances of complications increase compared to younger women.

The most frequent risks are represented by:

• Multiple pregnancy, especially if the woman undergoes IVF treatments. Multiple pregnancies cause premature birth, low birth weight, and delivery complications
• Gestational diabetes , which can cause health problems for the mother and baby
• hypertension ,
• Preeclampsia
• thrombosis
• Placenta previa , which may require bed rest, medication, or a cesarean delivery.
• Spontaneous abortion or stillbirth
• Caesarean section
• Part premature
• Low birth weight

The older a woman is, the more likely she is to have a pre-existing health condition that can complicate pregnancy and childbirth.

Age and parenting

A child requires considerable mental and physical energy .

A newborn imposes frenetic rhythms and often sleepless nights, a child who starts walking needs extraordinary attention, a child who starts attending kindergarten first and then school, in addition to extracurricular activities requires to be followed constantly .

Parenthood is not only giving birth to a child but also raising, educating and caring for him for as long as possible.

Parenthood  is the process of promoting and supporting a child’s physical, emotional, social and intellectual development from infancy to adulthood (cit. Wikipedia )

Becoming a mother at 50, 55 or even 60, thanks to assisted fertilization, increases the risk that it is that child who will have to take care of his parents from an early age .

It is a situation that must be evaluated however difficult it may be to accept and in opposition to the desire for a child.