Purpose: To provide the concept and details of the methodology of inducing ovulation in women in apparent menopause. Methods: A recent case is discussed and other previous publications described illustrating how to induce ovulation and achieve pregnancies despite what appears to be menopause. The various methods of lowering serum follicle stimulating hormone (FSH) and restoring down-regulated FSH receptors in granulosa theca cells of the follicle are described. Results: The newly reported case had two successful pregnancies after having a trisomy 15 in her first pregnancy. Conclusions: Women aged 42 and younger in apparent menopause have a reasonably good chance of ovulation induction and pregnancy by adhering to the tenets discussed, especially including lowering the elevated FSH in some way (the easiest and cheapest with ethinyl estradiol), using minimal or no gonadotropins, and supporting the luteal phase with progesterone.