The variability of female reproductive aging

Department of Reproductive Medicine, University Medical Centre, Utrecht, The Netherlands.
Human Reproduction Update (Impact Factor: 8.66). 11/2001; 8(2):141-54.
Source: PubMed

ABSTRACT The delay in childbearing is an important societal change contributing to an increasing incidence of subfertility. The prevailing concept of female reproductive ageing assumes that the decline of both quantity and quality of the oocyte/follicle pool determines an age-dependent loss of female fertility. There is an apparent discrepancy between the ability to maintain a regular ovulatory cycle pattern and the several years earlier cessation of female fertility. This latter is largely explained by an age-related increase of meiotic non-disjunction leading to chromosomal aneuploidy and early pregnancy loss, such that most embryos from women > or =40 years old are chromosomally abnormal and rarely develop further. The final stage of reproductive ageing-the occurrence of menopause-shows a huge variation between women. Age at last birth in natural fertility populations, which marks the end of female fertility, shows an identically wide variation as age at menopause, but occurs on average 10 years earlier. Given the high heritability for age at menopause, the variation in both age of menopause and last birth are probably under genetic control by the same set of genes. Some of those genes must carry heritable variants which modulate the rate of ovarian ageing and give rise to the wide age variations for the various phases of reproductive ageing.

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Available from: Peter L Pearson, Aug 25, 2015
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    • "Fertility significantly decreases with age, and the reduction of fertility is particularly noticeable after the age of 30 years; therefore, woman's age is one of the most important factors in determining fertility and ovarian reserve. As ovarian reserve physiologically decreases with age, the ovarian reserve according to the physiological age is lower than expected because of individual variability; this is known as diminished ovarian reserve (DOR) (Barad et al., 2007; Broekmans et al., 2009; te Velde and Pearson, 2002). The quality of oocyte also diminishes as a result of many factors during the lifetime , and leads to an increasing rate of aneuploidy. "
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    ABSTRACT: An increased accumulation of intracellular levels of reactive oxygen species with time may play an important role in the process of ageing. The antioxidant properties of resveratrol are dependent upon the up-regulation of endogenous cellular antioxidant systems. We evaluated whether resveratrol has protective antioxidant effects on ovarian damage related to oxidative stress in a rat model. Twenty-four female rats were randomly divided into three groups and were given saline (group 1: control); intraperitoneal cisplatin, 4.5 mg/kg, two weekly doses in total (group 2); or cisplatin, 4.5 mg/kg plus intraperitoneal resveratrol 10 mg/kg/day, 24 h before the administration of cisplatin (group 3). Serum anti-Müllerian hormone (AMH) concentrations were significantly lower in group 2 than in group 3 (P < 0.01 and P = 0.04, respectively). The evaluation of the atretic and antral follicle counts revealed statistically significant differences between the groups (P = 0.04 and P < 0.01, respectively). A statistically significant difference was observed in the follicle count positive for AMH between the groups (P = 0.01). Oxidative stress plays an important role in the process of ovarian ageing. Because of its natural antioxidant properties, resveratrol may be an effective option in protecting ovarian tissue against oxidative damage. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
    Reproductive biomedicine online 06/2015; DOI:10.1016/j.rbmo.2015.06.007 · 2.98 Impact Factor
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    • "Women nowadays are generally having children at an older age; this, combined with a natural reduction in fecundity associated with increasing age, has contributed to a rise in the occurrence of female infertility worldwide (Alviggi et al., 2009; Sharma et al., 2013; te Velde and Pearson, 2002; Ziebe and Devroey, 2008). In turn, this has resulted in an increase in the number of older (>35 years of age) women seeking infertility treatment through assisted reproduction techniques (Alviggi et al., 2009; Sharma et al., 2013). "
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    ABSTRACT: In this open-label study, women aged 36-40 years undergoing ovarian stimulation were randomized to recombinant human FSH (rhFSH) plus recombinant human luteinizing hormone (rhLH) from stimulation day 1 (group A; n = 103), or rhFSH alone (days 1-5) followed by rhFSH plus rhLH from day 6 (group B; n = 99). The primary objective was equivalence in number of oocytes retrieved per patient. The mean (±SD) number of oocytes retrieved was 9.7 (±6.9) in group A and 10.9 (±6.5) in group B; the estimated difference between groups (-1.28 oocytes [95% confidence interval: -3.15 to 0.59]) did not reach the predefined limit of equivalence (±3 oocytes). The study's primary objective was therefore not met. In both groups, a mean (±SD) of 1.9 (±0.6) embryos were transferred per patient. Implantation rates were 24.7% in group A and 13.3% in group B. Clinical pregnancy rates per started cycle and per embryo transfer were 31.6% and 34.4% in Group A, 17.2% and 18.9% in Group B. Ovarian hyperstimulation syndrome was reported in four (group A) and five (group B) patients. The potential benefit of initiating LH supplementation earlier during ovarian stimulation in older women is of interest, warranting further exploration. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
    Reproductive biomedicine online 06/2015; DOI:10.1016/j.rbmo.2015.06.002 · 2.98 Impact Factor
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    • "Menopause is defined as permanent termination of the primary functions of the ovaries, release of ova and hormones that causes uterine lining and shedding (Staessen et al., 2001). The average age of menopause is 51 yr (te Velde and Pearson, 2002). "
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    ABSTRACT: Menopause may increase risk of hypertension and abnormal lipid profile. The aim of the study was to examine the effects of morning and afternoon aerobic exercises on hypertension and lipids in overweight hypertensive postmenopausal women. Forty five women aged from 49 to 60 years were randomly assigned into three groups. Group (A) 15 patients received medicine, (B) 15 patients performed morning aerobic exercises and received medicine, and group (C) 15 patients performed afternoon aerobic exercises and received medicine. Blood pressure measurement and lipid profile tests were performed before and after the study. The results showed that there was a statistical significant difference among all groups in systolic and diastolic blood pressure, favoring group C. Also there was a statistical significant difference among all groups in lipid levels, favoring group C. Therefore, it can be concluded that morning aerobic exercises were more effective in reducing the blood pressure and lipids than afternoon exercises in overweight hypertensive postmenopausal women.
    06/2015; 11(3):145-50. DOI:10.12965/jer.150204
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