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A new term for the normal cessation of female fertility up to 10 years before the menopause, being apparent in some women after the age of 33 and most women by 45. Different from the perimenopause, which occurs as egg numbers fall far enough to cause shortening of the menstrual cycle, particularly the follicular phase, and accompanied by elevation of serum FSH when measured during menstruation. If pregnancies are attempted through the oopausal transition, a woman who has had no prior reproductive disturbance will typically experience recurrent miscarriages before developing otherwise unexplained infertility, manifesting in the IVF lab sequentially with unexplained implantation failure of apparently satisfactory embryos, then, in turn, a decreased rate of forming blastocysts, defective cleavage, and then failure of fertilization. There is no known method of overcoming its effects short of egg donation, except for some hope that the procedure of cytoplasmic transfer might be helpful
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