Reproduction at an advanced maternal age and maternal health.
Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction.
Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York. Electronic address: mvs9@columbia.edu.
Mark V
MV
Sauer
D000328:Adult; D000375:Aging; D005260:Female; D005298:Fertility; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D008423:Maternal Age; D008429:Maternal Welfare; D008593:Menopause; D008875:Middle Aged; D010353:Patient Education as Topic; D011247:Pregnancy; D012098:Reproduction; D027724:Reproductive Techniques, Assisted; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
Advanced reproductive age; advanced maternal age; assisted reproduction; maternal health; menopausal pregnancy