perimenopausal pregnancy rate

Last edited 02/2020 and last reviewed 02/2020

Fertility around the perimenopause is reduced.

Pregnancy rate in those not using contraception is (1):

  • 10-20 per 100 women years at 45
  • 5 per 100 women years at 50

Women should be informed that although a natural decline in fertility occurs with age and spontaneous pregnancy is rare after age 50, effective contraception is required until menopause to prevent an unintended pregnancy.

  • fertility naturally decreases as age increases, with women experiencing a relatively steep decline from the mid-30s onwards mainly due to diminishing quality and quantity of oocytes

  • the chance of pregnancy for a woman having unprotected sexual intercourse (UPSI) over the course of a year is around 10-20% for women aged 40-44 and closer to 12% for women 45-49. Spontaneous pregnancy is rare in women over 50

  • women over 40 who are sexually active should use contraception if they do not wish to become pregnant


  1. FFPRHC Guidance (January 2005) Contraception for women aged over 40 years Journal of Family Planning and Reproductive Health Care 2005; 31(1): 51-64
  2. FSRH (September 2019). Contraception for Women Aged Over 40 Years.