Progesterone supplementation is standard in both regular IVF, frozen embryo cycles, and donor egg transfers. Either the follicles are punctured for egg retrieval, or the woman didn’t ovulate at all that cycle and is getting an embryo produced at an earlier time or by someone else. It’s usually done with progesterone in oil shots in the US, but it’s also done with vaginal suppositories or gels like Crinone, and occasionally even with oral Prometrium.

I think the doctor in question phrased it as “uterine rejuvenation” because that sounded better than “regrowing uterine lining with estrogen”, or possibly the reporter took liberties with the description (media coverage of infertility is pretty terrible). I checked with my mom, who has 25 years’ experience as a reproductive endocrinology nurse; that’s how they treat their menopausal patients, and she’s not aware of any protocol other than standard estrogen/progesterone supplementation that would qualify. They’ve never treated anyone in her 60s, but they have treated women in their late 40s and early 50s, as well as younger women in menopause. The numerical age is less important than the hormonal profile, and a 50-year-old menopausal woman is no different from a 30-year-old with premature ovarian failure.

Late-life pregnancies are, almost without exception, donor-egg pregnancies. That means that the woman who gets pregnant doesn’t actually undergo the ovarian stimulation that is necessary to produce multiple follicles for IVF — some other, younger woman does. The intended mother merely takes a short course of estrogen, two weeks or so, which causes her uterine lining to grow enough to make pregnancy possible, and two weeks of progesterone after embryo transfer. The estrogen levels aren’t raised higher than normal as with ovulation induction — they are raised just enough to mimic a normally ovulating/menstruating woman.

So, the “extensive hormone maniuplation” we’re talking about, for donor egg late-life pregnancies, is roughly on par with a single month of HRT. It’s not really something to get that excited about.

I’m also skeptical about the risks of IVF hormones in older women. “Extensive hormone treatments” sounds scary, but when you look at the actual drugs and procedures, it’s not as bad. HRT is used for many months or years, while each IVF cycle only involves one to two weeks of ovarian stimulation, and two more weeks of progesterone supplementation (unless pregnancy is achieved). Furthermore, the estrogen levels are only raised above a normal ovulatory level according to how many follicles are produced, which is determined by the woman’s age and ovarian reserve. Menopausal women are hard to stimulate and frequently produce no more than three or four eggs, meaning that their E2 levels max out at only 3-4x normal. Perimenopause itself can cause that kind of transient elevation — it’s not uncommon for women to produce multiple eggs toward the end of their reproductive years, which is why twins are more common in this age group. The hormone elevations of pregnancy itself are orders of magnitude above and beyond that produced by the IVF process, and again, for much longer periods than brief IVF cycles.

Ovulation induction certainly is no picnic — I’ve had ovarian hyperstimulation, so I have a personal appreciation of the finer points. Nor am I a fan of late-life pregnancies in general, although I don’t think IVF clinics should be legally prevented from doing them. However, I do think that an IVF pregnancy at 50 is not qualitatively worse than a spontaneous one, and that talking about the “extensive hormone manipulation” involved is somewhat exaggerated.

Like, 99.99999% of the time throughout history, Moms (or their female relatives) were the caretakers of small children, which is labor intensive [no pun intended!] and exhausting work if you are doing it correctly. IE–not work for an old woman.

Men, meanwhile, could go on to mates number 2,3,and more as mate #1 died from childbirth or disease…and continue to impregnate young healthy women. So Papa dies…as long as the clan is there, no big problem. Mama dies = baby dies too. So the factory shuts down long before Mama runs out of natural time. It is not nice to fool Mother Nature, especially not to make a child who is created for YOUR needs, not for his or her own intrinsic value.