Is It Possible To Get Pregnant While You Are In Perimenopause?

In many societies, women are traditionally assigned with the roles of bearing and rearing children, mainly because women's reproductive role is essential for the continuation of human life. That's why — with more women joining the workforce and becoming the breadwinners of their families — we're seeing a steep decline in fertility rates worldwide. In the U.S., women of working age who entered the labor force increased from 34% to 57% between 1950 and 2016, according to Harvard Business Review. The fertility rate, on the other hand, has been slashed by half since 1950.

It is no surprise as women have become more educated and given the opportunity to shine in roles that do not involve feeding or cooking, they want to bask in that hard-fought sense of liberty and recognition for as long as they can. The average age at which women marry is rising, and more women are choosing to put off having children until they are emotionally prepared to do so. The cost of childcare, uncertain career opportunities, and the freedom of a child-free life are among the most often cited reasons for delaying pregnancies. Besides, advances in fertility technology are also making childbirth a viable option for women who are advanced in years, so there's no need to rush. But the question is: how long can a woman wait until she's fully ready to get pregnant? Is it possible to get pregnant while you're in perimenopause? Here are some insights.

You can still get pregnant in perimenopause

If you're entering the perimenopausal phase — which often begins 8 to 10 years prior to menopause — rest assured that the train is not leaving the station just yet. You can still get pregnant when in your late 30s and early 40s. "It really depends on where you are in the perimenopause process," ob-gyn Rachel Urrutia tells UNC Health Talk. "As you get closer to menopause, you don't ovulate as frequently. When you do ovulate, it may be a lower-quality egg, or the hormones associated with ovulation aren't optimal enough to support a pregnancy. So, for all those reasons, it's much less common to become pregnant—but it can happen."

To be fertile, a woman needs a high reserve of healthy eggs in her ovaries. Genetics and medical treatments can predispose a woman to low egg counts, which makes it more difficult to get pregnant. As a woman ages, her egg counts diminish naturally. Women are born with all of their eggs — approximately one million of them. In their twenties, women are most fertile and have the best chance of becoming pregnant. This is when women have the most good quality eggs at their disposal and their pregnancy risks are the lowest. From the age of 32 to 35, a woman's fertility begins to drop steadily and rapidly. By the age of 37, a woman will be down to 25,000 eggs. By the age of 40, she'll have about 18,000 eggs left. And the clock keeps ticking.

How to preserve a woman's fertility

Egg freezing, also known as mature oocyte cryopreservation, is a highly recommended treatment for women who want to preserve their ability to conceive a baby in the future. Egg freezing is the process of harvesting a woman's eggs from her ovaries, freezing them unfertilized, and storing them for later use. Most women keep their eggs in storage for five to ten years, but we've seen healthy babies being birthed from eggs that had been frozen for well over a decade. Once you're ready to use them, they will be fertilized in a lab and implanted in your uterus in a procedure known as vitro fertilization. 

A menopausal woman could potentially conceive and deliver a child using her own eggs if they were retrieved and frozen while they were still of good quality, ob-gyn Dr. Laurence C. Udoff tells The New York Times. Numerous studies suggest that women who freeze their eggs before the age of 35 have a greater probability of having a successful pregnancy. However, it's worth pointing out that egg freezing entails a tremendous amount of time and commitment. Patients who freeze their eggs typically spend around $30,000 and $40,000 on treatment and maintenance. According to a study published in the journal Human Reproduction, the overall chance of at least a live birth from the frozen eggs is 70 to 90% for women under 35 who freeze 10 to 20 eggs. That means egg freezing is no fertility insurance.