Perimenopause and Fertility Treatments

If you are experiencing problems getting pregnant, it may be the result of a variety of different factors. Issues such as physical health and wellbeing, as well as reproductive complications often play a role in infertility. If you are moving out of your reproductive years, age may also be playing a major role in your fertility struggle. Age is often the single most important factor when it comes to getting pregnant. So if you are heading towards perimenopause, you may want to consider some specific treatments helpful for restoring fertility in pre-menopausal women.

What is Perimenopause?
Perimenopause is the name given to the first stage of a woman's menopause. It is during perimenopause that you will typically experience the first signs that you are nearing the end of your reproductive years. Perimenopause can begin as early as age 35 or as late as age 60, however it usually begins when women are in their 40s and 50s. Perimenopause typically lasts between two and five years, but it can last more than ten years in some women.

What are the Signs of Perimenopause?
Some typical symptoms of perimenopause include:

 

  • irregular periods
  • spotting
  • hot flashes
  • mood changes

 

How Does Perimenopause Affect Fertility?
During perimenopause, your body's reproductive system begins to slow down. Your sex hormones (estrogen and progesterone) begin to decline, and as a result, your cycles may become irregular. Your ovaries will start to release fewer eggs and you may not ovulate every month. This can make it difficult for some women to get pregnant during perimenopause.

 

Testing for Perimenopause

If you are and your partner are having difficulties getting pregnant, you will probably both be tested for specific fertility issues. If you are over the age of 30, you may be undergoing perimenopause, and there are a few tests that your reproductive endocrinologist will likely perform.

Testing for Ovarian Reserve
As you age, your ovarian reserve will begin to decline. This happens to all women, beginning from the very day that they are born. Your health provider will want to check that you have a healthy number of viable eggs in your ovaries, and that you are ovulating normally. Typical tests for ovarian reserve include:

 

  • Day 3 FSH
  • Estradiol test
  • Clomiphene Challenge test

 

Depending upon the results of these tests, you and your partner will be able to decide if you need to pursue certain fertility treatments, or if you will turn to other options to conceive a child.

 

Fertility Treatments for Women Facing Perimenopause

If your tests indicate that you are entering perimenopause, there are some specific treatments available to you and your partner.

Clomiphene
Clomiphene citrate is a fertility drug that helps to induce ovulation. Women going through perimenopause often do not ovulate regularly, and Clomiphene can help to regulate ovulation and increase the number of eggs you release every month. Clomiphene can help produce pregnancy rates of up to 30% per cycle in some women. The medication is often used in combination with IUI procedures.

FSH
Follicle stimulating hormone, or FSH, can help to induce ovulation in some women experiencing perimenopause. Women with good ovarian reserves can use FSH to help stimulate ovulation and increase their chances of pregnancy. FSH is often used in combination with IUI. Pregnancy rates using FSH are approximately 5% per cycle, but they do begin to decline when you turn 40.

IVF
IVF treatment is often a very successful fertility treatment for women experiencing perimenopause. IVF treatment involves placing a fertilized egg directly into your uterus. Success rates for IVF treatments are as high as 25% in women under the age of 40. Pregnancy rates do begin to decline between the ages of 40 and 42, though.

Egg Donation
Egg donation is the most effective treatment available for women going through perimenopause. Egg donation involves fertilizing an egg from another woman with your partner's sperm. This fertilized egg is then implanted into your uterus. Egg donation is often a popular choice for perimenopausal women because it still allows them to experience pregnancy and childbirth. Pregnancy rates using donated eggs often reach 50% per cycle.

 

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