You Can Still Get Pregnant in Perimenopause—I Did

My husband, Aaron, and I had been trying for baby number two for over a year. After one intrauterine insemination (IUI), two unsuccessful rounds of IVF, countless hormones and endless stress and tears, we decided to defrost my frozen eggs. Six years prior, single after a series of bad breakups, I was certain I wanted to be a mom but uncertain I’d find a partner. So I made an impulse purchase and signed up with a fertility clinic to freeze my eggs.

Our son turned out to be fairly easy to conceive. At 37, after one miscarriage and five months of trying, I became pregnant. When we decided to have a second child when I was 39, I thought conceiving this time around would be just as certain. It wasn’t.

On Mother’s Day, the day before my 40th birthday, we learned that our first round of IVF didn’t work. My body and mind were exhausted. Balancing fertility drugs and treatments, caring for our toddler and recovering from three additional miscarriages in 10 months, I felt as though I were playing one of those carnival games—I bopped one miscarriage over the head, only for another pregnancy loss or failed fertility treatment to pop up, leaving us no closer to a baby.

How was this happening to me? There were six sets of twins and a set of natural triplets in my fertile Midwest Jewish family. The running joke was that my mom looked at my dad to become pregnant. “My body is failing our family,” I told Aaron. “Women much older than me are popping out babies everyday.”

Several months into this journey, a fertility acupuncturist I’d been seeing suggested I check my FSH (follicle stimulating hormone) again, which is often used to evaluate ovarian reserves—a higher FSH level means your body needs more of the hormone to stimulate ovulation and could indicate a decline in egg quality or quantity. For a woman my age, my FSH level should have been around an 8.

My FSH measured at 25.4.

I’d had my FSH levels tested during infertility treatments, and while my previous results weren’t great, they also were not cause for panic. I was almost 40 and understood that fertility begins to drop rapidly after 35. My new FSH level indicated I had officially fallen off the fertility cliff. I was in perimenopause.

What perimenopause means for fertility

Perimenopause. The word itself made me shiver. How could the word menopause be associated with me?

According to the Mayo Clinic, perimenopause means “around menopause” and begins for most women in their 40s. It is also called the menopausal transition. I looked and felt like I was in my early to mid-30s, but FSH levels indicated my eggs were the age of someone a decade older than me. My fertility doctor explained that about 1% to 2% of women hit perimenopause at my age. I could technically still become pregnant, but it would be a miracle.

How would I have approached my fertility process differently had I known I’d become perimenopausal in my late 30s? I believed I had plenty of time to easily conceive, but it turned out my mom had entered menopause at 42—in fact we had a strong history of early menopause in my family. Had I understood this, I would have likely frozen a dozen eggs as opposed to four, and I definitely would have had my FSH checked yearly, if not every six months. I certainly would have consulted with a fertility specialist sooner.

I was devastated. But Michelle Spina, my fertility acupuncturist and herbalist, helped me contextualize my perimenopausal fear. “You’re talking like your life is over. You know why you feel this way? Because nobody talks about perimenopause! It’s like the boogeyman for women in their 40s,” she said. “We’ve been conditioned to think that when we reach any stage of menopause, our sexuality is over and therefore we will be less valued. Can you imagine if we actually had conversations about all these menopausal stages? We would eliminate so much unnecessary fear.”

Faced with the prospect of my aging eggs, it was time to thaw the eggs I’d frozen six years earlier. After months of trying to expand our family, my eggs were defrosted, made into embryos, two of which were viable, and transferred to my uterus. This was it.

Two weeks later I went for a pregnancy hormone blood test. A couple of hours later, we were informed that I was not pregnant. I threw the phone across our bedroom. Our fertility journey was over. Even my 34-year-old eggs were too old.

Aaron and I decided not to discuss anything about fertility for at least a couple of weeks. When I could talk about the end of our fertility marathon without sobbing, we looked into one final option: using a donor egg from one of my sisters.

Both, without hesitation, agreed. We decided to move forward with my sister, Molly, mostly due to proximity. She lived close to us in New York, but we’d have to fly to a fertility center in Colorado for the procedure. Then COVID-19 hit and we were on lockdown. There would be no trip to Colorado. No donor egg.

“This is our last month trying,” I told my husband. “Are you sure? Don’t you think we should still try on your fertile days?” he asked. “No,” I said definitively. “I can no longer wonder month after month if my sore boobs and moody attitude are pregnancy or my period coming.”

But two weeks later, I took a pregnancy test. It was positive. “I’m pregnant,” I said in utter disbelief that those words were mine.

An unlikely pregnancy

Getting pregnant in perimenopause isn’t likely—but it is possible. “Until a woman goes for a full year without a period, we still consider her potentially able to conceive,” explains Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology at the Yale School of Medicine and a certified menopause clinician. “Physiologically, the ovarian function declines in perimenopause, but it’s not a straight line. Some days the ovaries are working and sometimes they are not. So, although fertility certainly diminishes as we get older, it doesn’t go to zero until you have a full year without a period.”

There are still mornings when I wake up and can’t believe I’m pregnant. Then I look down at my growing belly and realize it’s true. But this lengthy, painful, and ultimately joyful process has taught me that if there is an option, claim it. I thought my process was over many times, but there was always a tiny voice whispering that there must be another good egg in me somewhere. I’m glad that voice wouldn’t be silenced.

Susie Kantar-Cohen is a freelance writer. She is currently working on a memoir.

Originally Appeared on Glamour