Menopause marks the end of female fertility. This can be overcome by assisted reproductive technology to achieve pregnancy at any age by use of ovum donation with IVF and hormone replacement for embryo transfer. However, pregnancy is often hazardous for women over 45, with morbidity and mortality being increased around threefold due to increased risks of all obstetric complications. Risks to the children through prematurity are also significant and may cause lifelong disability or death. In childhood they may experience parental illness or bereavement. National fertility regulators in some countries, individual fertility clinics, and adoption agencies have all set parental age limits. Societal attitudes do not support post-menopausal pregnancy. Young egg donors also have reservations about giving to older recipients. Thus biologically, medically – both from the individual and public health perspectives – and sociologically, female age at menopause is a fair limit for ovum donation.