Can You Get Pregnant After Menopause?

Some things naturally get harder with age: hangovers, making new friends, standing up from the floor, and getting pregnant. A woman’s fertility declines over time and ends with menopause, when your menstrual period stops.

You can’t get pregnant naturally after menopause because your body is no longer releasing eggs. That said, you can get pregnant after menopause with in vitro fertilization (IVF), although it can come with risks.

Keep reading to learn everything you need to know about post-menopause pregnancy.

Menopause typically occurs between ages 45 and 55.

But for a small percentage of women, it can happen before 45, and for an even smaller group, before 40, says the menopause expert Mache Seibel, MD, a member of the medical advisory committee at the National Menopause Foundation and the author of several books on menopause and women’s health. (It’s important to note that some women enter medical menopause, for example if they have had their ovaries removed as a method of cancer prevention, Dr. Seibel adds.)

You’ve technically reached menopause when you haven’t had a period for 12 months. At that point, you have a 0 percent chance of getting pregnant naturally.

But your fertility declines for years leading up to menopause — and in fact, even earlier.

A woman is born with all the eggs she’ll ever have, and that reserve declines over time, says Seibel, who is board-certified in gynecology and reproductive medicine and is a North American Menopause Society (NAMS) certified menopause practitioner.

With age, a woman has fewer healthy eggs in her ovaries, and the overall health of those eggs declines, too, making it harder to get pregnant naturally during perimenopause, says Monica Christmas, MD, a board member of the Menopause Society, an associate professor of obstetrics and gynecology, and the director of the menopause program at UChicago Medicine. Eventually, ovulation slows and then stops completely.

Fertility peaks from the late teens to late twenties.

Your chances of getting pregnant start to decline by age 30, and that drop speeds up in your mid-thirties. By age 45, it’s a lot harder to conceive naturally, though still possible until you reach menopause. Only about 1 in 10 women in their forties or older will get pregnant in any given menstrual cycle.

If you don’t want to get pregnant, know that you should continue using birth control for the full 12 months after your last period.

This timing can get a little confusing, because there’s not always a clear end to menstruation. “Most people will experience changes to their menstrual cycle that could last for just a few months beforehand to up to a couple years beforehand,” Dr. Christmas says.

The menopausal transition isn’t linear: Fertility may be trending downward, Seibel says, but women may still have one or two healthy eggs. Occasionally, women think they’re no longer fertile and are surprised to discover they’ve gotten pregnant, he says.

Even though you can’t get pregnant naturally after menopause, you may be a candidate for IVF. During an in vitro fertilization procedure, a fertilized egg is implanted into the uterus.

If you froze eggs or embryos when you were younger, you can do IVF using your own eggs. If not, you’ll need to use donor eggs, because you won’t have enough or they won’t be healthy enough, Christmas says.

IVF combines an egg and sperm in a lab. Eggs are usually retrieved during a minor surgery after a woman has taken fertility medication that stimulates her ovaries to produce several additional eggs.

The egg is inseminated with sperm, and once the fertilized egg divides, it becomes an embryo. Healthy embryos can then be transferred to a woman’s uterus through a thin tube inserted in the vagina.

Even if you opted to use donated eggs for post-menopausal IVF, you’d be given hormonal treatments to mimic the hormone surge that would normally happen to prepare the uterine lining for pregnancy, Seibel says.

IVF isn’t always successful, and it results in fewer pregnancies and fewer live births in older women.

In fact, assisted reproduction technologies result in live births just 28 percent of the time in people older than 40.

While that’s less than the ideal success rate, it does mean it’s possible to get pregnant using IVF after menopause. There are even case studies documenting successful IVF post-menopausal pregnancies in women in their sixties (achieved, however, with egg donation, not the mother's own eggs).

IVF is currently the only assisted reproductive technology available that can facilitate pregnancy after menopause. Other parenting options after menopause include adoption and working with a surrogate.

People are getting pregnant later in life now: Births for women in their late thirties increased by more than 67 percent from 1990 to 2019.

And births to women ages 40 to 44 increased by more than 132 percent during that same time.

That’s due to a number of reasons, including education and career goals and financial concerns, Christmas says. And with the rise in popularity of egg freezing (and the number of employers now covering it as a work benefit), she says she thinks we’ll continue to see more pregnancies in older parents.

But there are a number of health risks for older mothers, and in what might seem like an unfair categorization, mothers are considered “older” as soon as they turn 35, Christmas says.

She says pregnancy complications with age include higher chances of:

Miscarriage and stillbirth
Chromosomal or genetic variations in the fetus (like Down syndrome)
Gestational hypertension
Gestational diabetes
Preeclampsia
Fetal growth restriction
Premature delivery

“The efficiency of the system is breaking down,” Seibel says. “The eggs are not as vital or vibrant, the uterine lining isn’t as perfectly ready, and so there are more miscarriages and losses.”

With age, you’re also more likely to be living with other health conditions that can make pregnancy more challenging, including diabetes and high blood pressure.

Seibel suggests talking with your primary care doctor and ob-gyn about your overall health before embarking on your journey to try to have a baby after menopause. They might suggest you undergo certain screening tests first to make sure you won’t be risking your health or the health of the fetus, he says.

The Takeaway

You can’t get pregnant naturally after menopause, which is defined as 12 months since your last period and typically occurs between ages 45 and 55. Fertility declines throughout your thirties and forties, making pregnancy difficult even before perimenopause, which is the period of time leading up to menopause. You can get pregnant using IVF after menopause, either with frozen eggs or embryos or donor eggs, but your risks of complications increase with age. Talk to your doctor about whether or not it would be safe for you to try IVF after menopause.

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