Women who are trying to conceive can encounter lots of misconceptions about fertility and menopause. Unfortunately, these myths can lead to confusion and needless anxiety for patients who are trying to get pregnant.
Women who go through perimenopause and menopause will experience changes in their ovulation cycle. These changes can make pregnancy extremely difficult.
A hysterectomy is a major surgery that removes the uterus. The surgery is often done for health reasons, such as uterine cancer or non-cancerous tumors called fibroids, which can cause a painful menstrual period and pelvic pain.
In most cases, doctors only recommend a complete hysterectomy if less-invasive options don’t work. Doctors can now use minimally invasive surgery, which requires general anesthesia but uses small incisions and results in fewer complications and shorter hospital stays. It’s important to ask your doctor if she does this type of surgery.
Before the operation, your doctor will give you antibiotics through a vein in your arm to lower the risk of infection. A catheter is placed in the urethra to drain your bladder during surgery and for a short time afterward.
After a complete hysterectomy, you can’t get pregnant. If your ovaries were removed as well, you’ll enter menopause. If they weren’t, you’ll continue to produce hormones at a reduced level. This can affect your mood and sexual pleasure, but researchers aren’t sure why.
Possible complications after a hysterectomy include wound infections, blood clots, and injury to surrounding organs. Having a hysterectomy is also associated with an increased risk of osteoporosis and heart disease. Women who have a hysterectomy should take calcium supplements to prevent bone loss. Women who had a complete hysterectomy often use hormone replacement therapy to reduce the risks of osteoporosis and hot flashes.
After menopause, your ovaries no longer produce hormones to stimulate egg development each month. But with IVF, you can use medications to stimulate ovulation and encourage the development of multiple eggs each month. Once you have multiple healthy eggs, they are combined with sperm in the laboratory and then transferred into your uterus for implantation.
In a natural pregnancy, an egg develops in one of your ovaries and then is released during the middle of each menstrual cycle. The egg then travels down the fallopian tube to find sperm, and once fertilized, it is implanted in the womb. The lining of the womb thickens as it prepares to receive the fertilized egg, and once the lining is thick enough, it is shed during your period.
Sperm are made in your testicles (the two egg-shaped organs contained within a pouch of skin called the scrotum that hangs below your penis). The sperm travel down the vas deferens, which joins with seminal vesicles and the prostate gland to form the ejaculatory ducts that carry semen out the penis into the urethra. The ejaculatory fluid contains mucus, which provides lubrication and helps the sperm survive. It also contains the sugar fructose, which provides sperm with energy to move.
Studies show that sperm morphology — or shape — decreases as you age, and this can make it harder for them to fertilize an egg. It’s unclear why this happens, but researchers suspect that testosterone levels decline and that a protein called sex hormone-binding globulin increases, lowering sperm concentrations further.
Those who are not able to produce eggs themselves can achieve pregnancy through a donor egg. Egg donation allows young women who may have premature menopause, or those with serious medical or genetic conditions to conceive. The procedure involves injecting the donor with a series of hormones to stimulate the ovaries to produce eggs. The eggs are then retrieved by ultrasound guidance. Donors are required to abstain from intercourse. Donors can either be designated by the couple seeking children or through agencies that connect them. At Yale Fertility Center, we ask all donors to be screened through an extensive process that follows recommendations from the American Society for Reproductive Medicine and the FDA. The process of conceiving through donated eggs can be long and expensive, but the results are excellent.
When a man ejaculates during sexual activity, the millions of sperm cells that are released travel down the penis, which holds many blood vessels that engorge with blood in response to excitement (this is what causes an erection). Sperm can survive for up to five days inside a woman, where they can fertilize her egg. The fertilized egg can then grow in the uterus, which is where a baby is born.
There are a number of reasons why women delay starting a family – career, higher education, or life commitments. However, with the advancement of fertility treatment, postmenopausal women can now become pregnant through the use of donated eggs.
The hormones that regulate fertility decline with age, causing menstrual periods to stop and symptoms like hot flashes and mood swings to occur. Women may also have difficulty conceiving even with the help of medical treatments or donor eggs. It is important to seek emotional support from friends and family members as well as a mental health professional during this time.
There are a few things that can be done to improve fertility after menopause, but they will depend on the specific situation. Women who have a hysterectomy, for example, cannot get pregnant because the uterus has been removed. However, they can still have sex and produce sperm that can be fertilized by another man. Sperm can be released from the body with a variety of sexual activities, including oral sex and masturbation.
In the case of a woman who has reached postmenopause, her menstrual period will have stopped for 12 months and she is no longer ovulating. Women can still experience sex after menopause, but they should use contraception as well to prevent pregnancy and STIs.
Women who are hoping to conceive after menopause should talk with their doctor about their options. Although it is possible to become pregnant after menopause, it is more difficult and there are higher risks for the mother and child. It is important to weigh these risks carefully before deciding on a course of treatment.