Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 185, Issue 3, Pages 758-770Publisher
MOSBY-ELSEVIER
DOI: 10.1067/mob.2001.114689
Keywords
fertility; reproductive aging; ovarian reserve; assisted reproduction; egg donation
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Reproductive capacity in women declines dramatically beyond the fourth decade of life. Oocyte quality seems to be the primary determinant of reproductive potential, although age-related uterine changes may also contribute. Underlying reasons for reproductive decline in women remain unclear, and both ovarian and neuroendocrine mechanisms have been proposed. A number of age-related endocrinologic changes precede menopause and predict diminished reproductive capacity. Thus, ovarian reserve screening may identify patients in whom attempts at conventional assisted reproduction is warranted before proceeding with ovum donation. Techniques to preserve the maternal genetic contribution to offspring (in lieu of egg donation), including germinal vesicle transfer and donor ooplasm, are under investigation.
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