title: Assessing fertility in women of advanced reproductive age.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, New York Presbyterian Medical Center, College of Physicians & Surgeons, Columbia University, New York 10032, USA.
authors.forename: J
authors.initials: J
authors.lastname: Klein
authors.forename: M V
authors.initials: MV
authors.lastname: Sauer
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D016922:Cellular Senescence / Q000502:physiology; D002996:Clomiphene; D004958:Estradiol / Q000097:blood; D005260:Female; D005298:Fertility; D005300:Fertility Agents, Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006728:Hormones / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis; D008875:Middle Aged; D009865:Oocytes / Q000502:physiology; D010060:Ovulation; D012098:Reproduction / Q000502:physiology; D014599:Uterus / Q000254:growth & development
chemical_list: D005300:Fertility Agents, Female; D006728:Hormones; D002996:Clomiphene; D004958:Estradiol; D005640:Follicle Stimulating Hormone