I remember hearing news reports of women in their 50s, already in menopause, becoming pregnant. However, I don't remember the details. Is this possible? Did these women have fertility treatment?

A.

Once menopause has occurred, there are no longer eggs within the ovary. The only way to achieve a pregnancy is with the use of egg donation. Egg donation is widely available across the United States and many other countries. Most programs will either provide an anonymous egg donor or work with a younger egg donor of your choice.

The egg donor receives daily injections of medication to stimulate the development of the eggs. Once the follicles are mature, the donor receives an injection of hCG to trigger maturation of the egg. About 36 hours later, the eggs are "harvested" during an egg retrieval procedure performed under intravenous sedation. The eggs are taken to the laboratory and mixed with sperm from your partner or a donor if you so choose. If there is a male fertility problem, a technique called ICSI (sperm injection) offers many men the opportunity to fertilize the eggs, where previously that was not possible.

While all this is going on, the recipient is receiving medication to synchronize the growth of the uterine lining so it is ready to accept the embryos at the appropriate time. This can be tricky, but the steps have been worked out, and in most women the success rates with egg donation are even higher than normal IVF.

One word of caution: Pregnancy in older women can be associated with increased risks of complications such as eclampsia, seizures, stroke and death. A thorough medical evaluation must be carried out before entering into the program.