Perimenopause, GLP-1s and Egg Freezing Explained

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Previously titled “The Fertility Expert: Egg Freezing, Perimenopause & GLP-1s Explained” — renamed by the publisher on Aug 3, 2026

The Tamsen Show 39 min 2 speakers 3 chapters transcribed 2 months ago
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Can you still get pregnant during perimenopause and how common is pregnancy at age 40?

Tamsen Fadal 0:05
Welcome back to The Tamsen Show. So if you are in your late 30s or early 40s and you feel like your body doesn't quite respond the way it used to, you are not imagining it, especially if you've had a baby in the last few years or more than one. A lot of women move from pregnancy to postpartum straight into perimenopause without anyone saying that out loud. So when your sleep is off, your mood feels unpredictable, cycle changes, anxiety spikes or energy drops, you're left trying to figure out what box you're in. Most doctors don't walk you through that overlap, but today we're gonna change that. Joining me in our Soho studio is Dr. Jamie Griffo. He is a Director of Reproductive Endocrinology and Infertility at NYU Langone.
Tamsen Fadal 0:47
Dr. Griffo has helped modernize IVF as we know it today. And his work has shaped how doctors understand fertility, hormones, and reproductive aging. And he's here to give us language for what's happening in your body and the confidence to act on it as well. Welcome to The Tamsen Show. Good to see you.
Dr. Jamie Grifo 1:08
Good to see you. Thank you.
Tamsen Fadal 1:09
Yes, of course.
Dr. Jamie Grifo 1:10
It's great to be able to help educate women to understand their bodies and their systems and what goes on.
Tamsen Fadal 1:15
I feel like there have been so many questions that we have not had answered for decades now.
Dr. Jamie Grifo 1:20
Well, unfortunately, we suffer from lack of good science, good studies, and that needs to change because this generation of women has really been left out in the cold with the way we handle perimenopause, menopause, and beyond.
Tamsen Fadal 1:35
Well, there's so many questions I want to ask you. I want to start by clearing things up just because you bridge the gap in these areas of perimenopause, postpartum, pregnancy. You're talking about a little bit of all of it every day. So for people who are listening and might not understand all these different areas, can you still get pregnant in perimenopause?
Dr. Jamie Grifo 1:55
Yes, you can. It's less likely. And you really have to start from the beginning and think about where we started as a species about 300,000 years ago. We didn't live very long. Menopause wasn't a thing. We were dead before menopause happened. And the whole female reproductive system was designed by mother nature. And it had one thing in mind, we had to survive. And life was harsh. And the way we survived was had the right number of babies, not too many, not too few. So the system was designed that you as a fetus in your mother's womb had seven million eggs for no good reason because by the time you were born, a million were left. And by the time you hit puberty, 300,000 were there. And every month, your body through the hormones in your pituitary tell your ovary to make you an egg.
Dr. Jamie Grifo 2:40
And in that process, that's where the hormonal shifts occur. Eggs, a bunch of eggs, 500 start growing, one gets selected, estrogen levels go up. That signals the surge to make you ovulate. Ovulation happens now, progesterone comes up with the estrogen and you get the cyclic nature of estrogen, estrogen, progesterone. the lining of the uterus is receptive for that embryo to implant. If there's no embryo, you bleed. If there is an embryo, it implants. If it's a healthy embryo, you get a baby. If it's an unhealthy embryo, you can just have a positive test, or you can have a miscarriage, or you can have an unfortunate event where you get to 16 weeks pregnant, your baby has a genetic abnormality like Turner syndrome, Edwards syndrome, Down syndrome, Klinefelter syndrome, and younger eggs do better.
Dr. Jamie Grifo 3:26
And the system was designed for 14 year olds who were dead by 25 to have only three babies from those 80 eggs that they ovulated in their whole lifetime from the 7 million they had in their ovary as a fetus.
Tamsen Fadal 3:38
So that's where we started.
Dr. Jamie Grifo 3:39
That's where we started.
Tamsen Fadal 3:40
And what was the average age a woman would have her first?
Dr. Jamie Grifo 3:44
Back then in the beginning, it was like 14. And by the time you were 25, you had to have three living children. So the system was never the efficiency we were taught in that third grade sex ed class where it made it sound like every time you had sex, you'd get pregnant.

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