There are limited options for treating older women who are menopausal or peri-menopausal. Older women usually respond poorly to ovarian stimulation and the live birth rates even with IVF treatment are significantly lower than with younger women. The older women are at increased risk of having medical problems in their pregnancies and deliveries. In order to improve the success rate of IVF treatment in older women, some clinics recommend assisted hatching, blastocyst embryo transfer, and preimplantation diagnosis and only transfer normal embryos. Furthermore in some countries the transfer of high number of embryos is recommended. Other options of treatment include egg donation using eggs donated by younger woman, embryo donation if the male partner also has a sperm problem, surrogacy if a woman (traditional surrogate) agrees to become pregnant using the male partner sperm and her own eggs, adoption and foster care and accepting child-free living.