title: Advanced reproductive age and fertility: no. 269, November 2011.
abstract: OBJECTIVE
  To improve awareness of the natural age-related decline in female and male fertility with respect to natural fertility and assisted reproductive technologies (ART) and provide recommendations for their management,and to review investigations in the assessment of ovarian aging.
  
  
  METHODS
  This guideline reviews options for the assessment of ovarian reserve and fertility treatments using ART with women of advanced reproductive age presenting with infertility.
  
  
  RESULTS
  The outcomes measured are the predictive value of ovarian reserve testing and pregnancy rates with natural and assisted fertility.
  
  
  METHODS
  Published literature was retrieved through searches of PubMed or Medline, CINAHL, and The Cochrane Library in June 2010, using appropriate key words (ovarian aging, ovarian reserve, advanced maternal age, advanced paternal age, ART). Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated into the guideline to December 2010.
  
  
  METHODS
  The quality of evidence was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice were ranked according to the method described in that report (Table).
  
  
  RESULTS
  Primary and specialist health care providers and women will be better informed about ovarian aging and the age-related decline in natural fertility and about options for assisted reproductive technology.
authors.forename: Liu
authors.initials: L
authors.lastname: Kimberly
authors.forename: Allison
authors.initials: A
authors.lastname: Case
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Cheung
authors.forename: Sony
authors.initials: S
authors.lastname: Sierra
authors.forename: Saleh
authors.initials: S
authors.lastname: AlAsiri
authors.forename: Belina
authors.initials: B
authors.lastname: Carranza-Mamane
authors.forename: Allison
authors.initials: A
authors.lastname: Case
authors.forename: Cathie
authors.initials: C
authors.lastname: Dwyer
authors.forename: James
authors.initials: J
authors.lastname: Graham
authors.forename: Jon
authors.initials: J
authors.lastname: Havelock
authors.forename: Robert
authors.initials: R
authors.lastname: Hemmings
authors.forename: Francis
authors.initials: F
authors.lastname: Lee
authors.forename: Kimberly
authors.initials: K
authors.lastname: Liu
authors.forename: Ward
authors.initials: W
authors.lastname: Murdock
authors.forename: Vyta
authors.initials: V
authors.lastname: Senikas
authors.forename: Tannys D R
authors.initials: TD
authors.lastname: Vause
authors.forename: Benjamin Chee-Man
authors.initials: BC
authors.lastname: Wong
mesh_terms: D000367:Age Factors; D005260:Female; D005298:Fertility; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D008297:Male; D010050:Ovarian Function Tests; D010053:Ovary / Q000502:physiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted