Early Menopause

Treatment

The chance to conceive is directly related to the number of folliclesfollicles and eggs left in ovaries. Women in the relatively early stages in the process toward early menopause (i.e., women with POAPOA ) have fewer follicles and eggs than they should at their age, but they usually still have enough for a good chance of pregnancy. In contrast, POF patients (i.e., women who are already in early menopause) are often down to such a small enough pool of follicles and eggs that they no longer have a realistic chance at pregnancy with use of their own eggs.

DHEA Supplementation and IVF

"With ovaries prematurely aging but not yet in early menopause, we can still help most women get pregnant, typically with in vitro fertilization (IVF)."

Center For Human Reproduction: Dr. Norbert Gleicher, best fertility specialist in the US Dr. Norbert Gleicher

With POA, women usually still have a reasonable likelihood of achieving pregnancy with their own eggs, as opposed to donor eggs. Supplementation with dehydroepiandrosterone (DHEA)dehydroepiandrosterone (DHEA) , a mild male hormone treatment introduced into fertility care by CHR physicians, has played a crucial role in vastly improving treatment outcomes of younger patients with POA (early pre-menopause) and older DORDOR patients. DHEA helps to rejuvenate ovarian function, helping women produce more better-quality eggs in preparation for IVF.

As reported in 2007, DHEA supplementation prior to IVF cycles more than doubled pregnancy rates [Barad et al. J Assist Reprod Genet 2007;24(12):629-34]. Our published data since then have shown that DHEA supplementation improves pregnancy rates, improves egg and embryo quality and reduces chromosomal abnormalities. At CHR, careful DHEA supplementation, coupled with aggressive ovarian stimulation protocols, has been an integral part of our treatment approach for women with on the unfortunate path toward early or premature menopause.

DHEA supplementation with POF, or outright early menopause, is still under investigation but appears much less successful. In contrast to women with POA, women in early menopause in most cases still needs egg donation to conceive.

IVF with Egg Donation

In vitro fertilization (IVF) with egg donation is a very effective treatment option for women with early menopause who want to conceive. In egg donation cycles, eggs are retrieved from a young donor with normal ovarian reserve (who are typically anonymous in our program), and fertilized using the patient’s partner's (or donor's) sperm. After a few days, embryos are transferred into the patient’s uterus.

Egg donation from young egg donors circumvents the problems of poor egg quality and small number of eggs, typical problems women in early menopause face. Because of the much higher egg quality and simply a larger number of eggs being available, pregnancy chances are much higher with egg donation. Indeed, recipients have the pregnancy chances and miscarriage risks of women at the egg donors' age and ovarian reserve status. Cumulative pregnancy rates from a single donor IVF cycle at CHR, therefore, have been consistently in the high 80s to low 90s.

Read more about Early Menopause

What Is Early Menopause?

The average age at which women typically experience menopause is around age 51...

Read more

Diagnosis

Early menopause is the last stage of usually a lengthy process of premature ovarian aging (POA)...

Read more

Last Updated: November 15, 2014

Additional Resources

Whole-Body Effects of Menopause A rather well designed recent study in Proceedings of the National Academy of Sciences U.S.A. (Levine et al., 2016;113:9327-9332) offers sur...

VIEW ALL RELATED ARTICLES 

Treating the older female patient It does not happen too often that prominent medical journals express gratitude to authors for submitting manuscripts; but this is

VIEW ALL RELATED ARTICLES 
Get a Second Opinion
second opinion cta

1/3 of women who have been told they need egg donation actually wind up conceiving at the CHR with their own eggs.

LEARN ABOUT CHR´S SECOND OPINION PROGRAM