The variability of female reproductive aging

Department of Reproductive Medicine, University Medical Centre, Utrecht, The Netherlands.
Human Reproduction Update (Impact Factor: 10.17). 11/2001; 8(2):141-54.
Source: PubMed


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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    • "To date, little information is available concerning the reproductive characteristics of women diagnosed with POI during their preceding reproductive life (Bachelot et al., 2009; Janse et al., 2010). On the basis of data from general population studies, it is thought that, for a given woman, a fixed time interval exists between the various reproductive phases, i.e. the onset of subfertility, infertility and the subsequent age at menopause (Broekmans et al., 2009; te Velde and Pearson, 2002). Menopause generally occurs around the age of 51 years, with an age range extending between 40 and 60 years (Treloar et al., 1967). "
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    • "Age related decline in reproductive performance in women is well documented [American College of Obstetricians and Gynecologists Committee on Gynecologic Practice; Practice Committee of the American Society for Reproductive Medicine 2014; Spira 1988; te Velde and Pearson 2002]. "
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    • "From a biological point of view, the optimal period for a woman to have children is between ages 18 and 30 years. Thereafter, the ability to conceive and have children declines progressively (Bongaarts, 1975; Wood, 1989) because of depletion and ageing of the pool of oocytes stored in the ovaries during the fetal period (te Velde and Pearson, 2002). The advent of reliable methods of contraception in the 1960s enabled women to postpone childbearing, to prevent the birth of not yet wanted children, and to plan the start of building a family (Goldin, 2006). "
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