At present, we live in the era of family planning and the emancipation of the female workforce, experiencing an ever-increasing life expectancy. At the same time, there appeared freedom and the ability to postpone the age of procreation and facilitate conception. However, for some women, this delay can lead to the need for assisted reproductive technology (ART) to achieve pregnancy or even inability to conceive at all. Although the calendar or the “chronological age” is very closely related to the biological or “reproductive age”, they can also be separate entities.
This means that, although some women can easily achieve a spontaneous pregnancy at the age of 35, others may have already missed their window with the best opportunities. We will cover the main aspects of the reproductive physiology of an aging woman, as well as demographic data and the consequences of deferred reproduction, in this and future blog posts.
Reproduction Strategies in Advanced Age
In practice, most women will be able to carry out pregnancy successfully. Those who do not and have clear reasons for their sub- or infertility, such as tubular factor, azoospermia or anovulation, can take advantage of targeted treatment strategies for their problem. However, when the quantity or quality of the reduced oocyte underlies involuntary childlessness, the solution is less simple. To date, there are no known ways to increase the quantity of oocytes or improve the quality of oocytes.
Currently, the treatment of ovarian aging is more preventive: it is recommended that women do not delay pregnancy for too long and take into account lifestyle habits such as smoking as a permanent threat factor for their (future) fertility. In the late stage of ovarian aging, donation of oocytes, using eggs that form young or at least formerly fertile women may be the only remaining option for the treatment of a viable euploidic pregnancy.
Key takeaways on this topic may be:
Reproductive aging in women is associated with a decrease in the quantity and quality of oocytes,
Decrease in the quantity of oocytes ultimately leads to the onset of menopause, whereas a decrease in the quality of oocytes leads to an increase in the proportion of chromosomal abnormalities,
Reproductive aging is associated with a loss of fertility and an increase in the rate of miscarriages,
The quantity of oocytes can be measured using proxy markers, but there are currently no available oocyte quality markers,
In addition to prevention, there are currently no options for treating the consequences of reproductive aging in women.