Pregnancy After Menopause: Fantasy – Yes, Crazy – No, We Can Make it Happen

Ronny Cammareri: …why didn’t you wait for the right man…? Loretta Castorini: He didn’t come!Ronny Cammareri: I’m here! Loretta Castorini: You’re late!

So the love of your life came too late and your last period came too early. Pregnancy,then,must be out of the question? Not so. With the use of donor egg IVF your fantasy of family can be realized.

Here’s how it works: The intended mother,or recipient, is matched with a young (age 19 – 30),healthy “egg donor” whose physical characteristics and cultural background are similar to her own. Most egg donations are anonymous (donor and recipient never meet and the donor never learns if there is a pregnancy resulting from the donation) but designated donation between known parties can also be executed. Both donor and recipient are prescribed regimens of hormonal treatments: the donor’s to develop multiple eggs (usual yield 15 – 20), the recipient’s to prepare her endometrium, or uterine lining, to receive embryos created from the fertilization of the donated eggs with her partner’s sperm. The embryos,once created, are cultured and grown for five days. The goal (as with autologous IVF) is to have two well – expanded blastocyst-staged embryos to transfer to the uterus of the intended mother. Supernumary embryos of equal quality may be cryopreserved for future attempts to create or expand a family.

A patient will often ask if her uterus won’t “reject” embryos that are made with someone else’s eggs. Embryos, even if created with ones own eggs, are always “non-self”. The egg contributes only half of an embryo’s DNA – the sperm the remainder. The uterus is an immunoprivileged environment which, for the most part, “allows” these embryonic foreign bodies to implant, grow, thrive, and resist rejection.

Another oft-asked question concerns the preparation of the endometrium to receive embryos. Won’t the uterus “know” that the hormones that are prescribed for this purpose are exogenous drugs and not naturally occurring? Fortunately the uterus is not very discriminating. It does not “care” if the estrogen and progesterone required for endometrial development are secreted by a person’s ovaries or are adnministered via transdermal patch, tablet, cream, or vaginal suppository. And with donor egg pregnancies, just as with those that arise naturally, the placental pharmacy begins to function in the latter third of the first trimester and all hormone medications can then be stopped. Donor egg pregnancies then proceed just as and are indistinguishable from pregnancies conceived with a woman’s own eggs.

For patients the hardest part about donor IVF is deciding whether it is right for them. While participation in the program is undertaken with hopes and anticipation of the gains of pregnancy and parenthood it also signifies acknowledgement of the loss of a woman’s own reproductive potential. The mixed bag of emotions that surfaces when the use of donor eggs is being considered should be discussed with a patient’s physician, staff, or a skilled therapist. Once a couple has decided to go ahead they most often proceed with great excitement and anticipation. The eggs, once retrieved, are the patient’s and any pregnancy derived from these eggs is experienced exactly as would be a pregnancy generated from her own DNA. Nobody has ever reported an out-of-body experience carrying a pregnancy derived from donor eggs!

If a woman is healthy, of normal weight, and does not smoke pregnancy after menopause is a popular option for family building. How old is too old and at what age is pregnancy risky to a woman’s health? These are important questions that should be discussed at length between prospective donor egg recipients and their physicians. For the most part, however, recently menopausal women in their late 40s and early 50 are excellent candidates for donor egg IVF. Who says you can’t have everything?