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Perimenopausal conception.
Basil C Tarlatzis1, Leonidas Zepiridis
11st Department of Obstetrics and Gynaecology, Unit for Human Reproduction, Aristotle University of Thessaloniki, Thessaloniki, Greece. tarlatzis@hol.gr
Annals of the New York Academy of Sciences
|December 3, 2003
Summary
Female fertility significantly declines with age, particularly after 35, due to decreased ovarian reserve and oocyte quality. Oocyte donation offers high success rates for perimenopausal women, while ovarian tissue cryopreservation shows future promise.
Area of Science:
- Reproductive Endocrinology
- Gynecology
- Human Reproduction
Background:
- Female fertility naturally declines with age, becoming more pronounced after 35.
- This decline is primarily linked to reduced ovarian reserve and oocyte quality, including increased aneuploidy.
- Factors like endometriosis, pelvic inflammatory disease (PID), and toxic exposures can further impact fertility.
Purpose of the Study:
- To review the age-related decline in female fertility.
- To discuss current and potential future reproductive technologies for women of advanced reproductive age.
- To evaluate the efficacy of various fertility treatments in perimenopausal women.
Main Methods:
- Literature review of age-related fertility decline.
- Analysis of success rates for ovulation induction, in vitro fertilization (IVF), and preimplantation genetic diagnosis (PGD).
- Evaluation of oocyte donation and ovarian tissue cryopreservation outcomes.
Main Results:
- Spontaneous conception rates are low in perimenopausal women, with higher complication risks.
- Standard IVF shows poor implantation, clinical pregnancy, and live birth rates in advanced maternal age.
- Oocyte donation demonstrates high cumulative birth rates (approx. 80% after four cycles).
- Ovarian tissue cryopreservation shows promise but has not yet resulted in human pregnancies.
Conclusions:
- Biological age is a better predictor of fertility than chronological age.
- Oocyte donation is the most reliable option for perimenopausal women seeking pregnancy.
- Future advancements in fertility preservation and treatment hold potential for older women.