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Determination of Reproductive Competence by Confirming Pubertal Onset and Performing a Fertility Assay in Mice and Rats
Published on: October 13, 2018
Advanced reproductive age and fertility
1Toronto ON.
Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
|November 16, 2011
Summary
Female fertility naturally declines with age, impacting both natural conception and assisted reproductive technologies (ART). Awareness and timely intervention are crucial for managing age-related infertility risks in women and men.
Area of Science:
- Reproductive endocrinology and infertility
- Maternal-fetal medicine
- Genetics and aging
Background:
- Fertility in both women and men naturally decreases with advancing age.
- This age-related decline affects outcomes for both natural conception and assisted reproductive technologies (ART).
- Ovarian aging is a significant factor in female fertility reduction.
Purpose of the Study:
- To enhance understanding of age-related fertility decline in females and males.
- To review methods for assessing ovarian reserve and fertility treatments.
- To provide evidence-based recommendations for managing infertility in advanced reproductive age.
Main Methods:
- Systematic literature search of PubMed, Medline, CINAHL, and Cochrane Library up to December 2010.
- Inclusion of systematic reviews, RCTs, CCTs, and observational studies.
- Quality of evidence and recommendations ranked using the Canadian Task Force on Preventive Health Care criteria.
Main Results:
- Ovarian reserve testing has limited predictive value for pregnancy, primarily useful for excluding specific cases.
- Pregnancy rates with ART, except egg donation, are significantly lower for women in their late 30s and 40s.
- Advanced maternal and paternal age are associated with increased risks of pregnancy complications and offspring conditions.
Conclusions:
- Counseling on age-related infertility risks should be integrated into routine reproductive healthcare for women in their 20s and 30s.
- Women over 35 should undergo infertility work-up after 6 months of trying; ovarian reserve testing can be considered for specific risk factors.
- Oocyte donation is the most effective treatment for ovarian aging; advanced paternal age carries small but notable risks that warrant counseling.
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