Fertility tips for women nearing menopause, as revealed by the doctors

Menopause marks the end of periods as a hormonal milestone and though most women experience menopause by the age of 52, certain genetics, underlying conditions or pelvic or ovarian damage may cause sudden menopause earlier in life. It is the natural suspension of a woman’s menstrual cycle that marks the end of fertility.

Many women find themselves trying for conception in their late thirties and forties, a period which is nearing menopause. In an interview with HT Lifestyle, Dr Astha Gupta, Consultant – Reproductive Medicine at Delhi’s Milann Fertility Hospital, shared, “It is often wondered if there is a fertility boost in the years leading up to menopause. Since the body naturally stimulates the ovaries more aggressively, there may be a tiny relative rise. However, this occurrence has not been thoroughly investigated and validated.”

She added, “Although postmenopausal eggs are no longer viable and also there is high risk of having baby with birth defects, there are still two methods to use IVF. One can use eggs frozen in the past when the women was menstruating (social egg freezing) or fresh frozen donor eggs. Hormone therapy is also required to prepare your body for implantation and to carry a baby to term. Hormone replacement therapy is given to resume menstruation for atleast three months before the embryo is transferred in uterus.”

Highlighting that recently new upcoming therapies like ovarian PRP( platelet rich plasma) and stem cell therapy are being offered for ovarian rejuvenation, Dr Astha Gupta said, “They may help some patients who don’t have frozen eggs and cannot accept donor eggs due to religious or cultural issues. In this scenario, fertility professionals frequently offer Clomid (clomiphene citrate), an oral drug, or an injectable hormone. FSH levels are raised as a result of these medications, causing the body to release more than one egg per month.”

According to Dr Pundalik Sonawane, Obstetrician and Gynecologist and Professor and Head of Department of Obstetrics and Gynecology at Mumbai’s KJ Somaiya Medical College, spontaneous and natural pregnancies do occur in thirties and forties but overall fertility chances are reduced due to depletion of quality and quantity of ovarian reserve of oocytes. She said, “Fertility can still be accomplished by ovarian stimulation or taking donor oocytes through In Vitro Fertilization Techniques. Women should be made aware of the complications of pregnancy at such advanced maternal age such as abortion, complications due to the mother having diabetes and hypertension, higher chances of chromosomal anomalies and birth defects in the baby, and adjustment difficulties of post delivery period.”

For successful pregnancy outcome in this period, she advised that women should maintain a healthy and stress-free lifestyle, undergo regular health check-ups, ensure good control of blood pressure and diabetes and must seek preconceptional counselling from an expert gynaecologist. It is no secret that some people assume that it is not possible to conceive once symptoms of perimenopause, such as hot flashes and irregular periods, appear. However, Dr Gayatri Kartik- HOD and Consultant – Obstetrics and Gynaecology at Bengaluru’s Manipal Hospitals, insisted, “We (doctors) will leave a person’s menopausal only after periods have been absent for more than 12 months. Anyone seeking to conceive during perimenopause should speak with a gynaecologist about their choices.”

She added, “While fertility is likely to decline, there are ways to improve your chances of becoming pregnant in the perimenopausal age group. These include noting the presence of an increased thin watery vaginal discharge and subsequent breast tenderness which are natural signs of ovulation and indicate the best time to try to conceive. Lifestyle factors, such as diet and exercise: a well-balanced, nutritious diet and regular exercise can boost overall health, which may increase the chances of conception. If cycles have become irregular, It may be good to consider In vitro fertilization (IVF). It is possible to conceive with the help of assisted reproductive technology, such as IVF, both during perimenopause and after menopause. However, it is advisable to consider freezing of eggs or embryos in people who are planning to postpone childbearing to the late thirties or early forties.”

Echoing the same, Dr Parul Monga, MBBS, MS – Obstetrics and Gynaecology, at Chandigarh’s Ayu Health Hospitals, asserted, “It’s important to approach fertility issues holistically, believing that our fertility is influenced by the interconnection of our physical bodies, minds and the environment in which we live; all of these factors work together to promote total health and well-being. So, during perimenopause, one of the key goals of your natural fertility program should be to maintain your adrenal glands, eat a nutrient-dense diet, manage stress, support emotional health, and exercise regularly. The adrenal glands work to support not only a healthy stress response during perimenopause but also hormonal balance, which is important for a healthy menstrual cycle and pregnancy.”

She elaborated, “Supporting their function during this time may also help you avoid a symptom-ridden transition to menopause when the time comes. A nutrient-dense, whole food diet rich in fresh leafy vegetables, fruit, whole grains, nuts, seeds, and fibre is important for vitality, fertility health, as well as egg and sperm health. One should limit, or avoid processed meats and processed foods. Simultaneously, exercise regularly as it boosts blood flow throughout the body and helps to ensure a healthy body, and relieves stress. Find something you enjoy doing! A few examples of exercises are walking, leisurely running, dancing, swimming, and yoga. It’s crucial to remember that each woman’s reproductive cycle is unique, so talk to your doctor and get precise advice.”