Skip to main content Accessibility help
×
Home
Hostname: page-component-99c86f546-pkshj Total loading time: 0.326 Render date: 2021-12-03T20:22:58.942Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

19 - Assisted reproductive technology and older women

Published online by Cambridge University Press:  22 October 2009

Paul Serhal
Affiliation:
Assisted Conception Unit, UCLH, London, UK
Paul Serhal
Affiliation:
The University College London Hospitals
Caroline Overton
Affiliation:
Bristol Royal Infirmary
Get access

Summary

The life expectancy of women has increased significantly over the past century and the advent of efficient contraception has given women the opportunity to choose when to have children. At present many women delay childbearing for a variety of social and economic reasons, including higher education, a career and economic pressure to remain at work, that have contributed to a constant increase in older women seeking treatment for infertility (Medical Research International, 1990). The trend towards older parenting is evident in the general population (Baldwin & Windquist Nord, 1995) and the number of births for every thousand British women in their early 30s has exceeded that of women in their early 20s (Office of Population Censuses and Surveys, 1994).

Fecundity

Female fecundity is generally acknowledged to decrease by the age of 30 years (van Noord-Zaadstra et al., 1991; Leridon, 1977). The decline is gradual until a rapid decline from the age of 35 years and by the age of 45 years fecundity is almost lost (Navot et al., 1987).Women aged over 35 years take longer to conceive and a higher proportion will never achieve a pregnancy when compared to younger women (Navot et al., 1991). This decline is related to a process of follicular depletion and diminished oocyte quality.

Follicular depletion

The ovarian function is limited by the size of the follicular store laid down prenatally. Approximately seven million human germ cells are formed in fetal ovaries, with only two million remaining at birth and around 300 000 remaining at the menarche (Gosden, 1987). The reduction in the number of oocytes is a dynamic process that continues throughout a woman's premenarcheal and menstrual life.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats
×

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats
×