The futile case of the aging ovary: is it mission impossible? A focused review

Abstract

Despite immense and impressive progress in the field of reproductive medicine, little has been achieved in terms of replenishing aged ovaries and improving their reproductive outcome. Age causes irreversible damage to human eggs in terms of quantity as well as quality. Nature probably designed women to reproduce best in their twenties and thirties. However, due to social, personal, career, educational and financial pressures, women delay pregnancies until their late thirties, by which time the chance of becoming pregnant is compromised by low fecundity rates and an increased risk of miscarriage. Age, unfortunately, is the most detrimental prognostic factor for success of fertility treatment. We have seen an increasing population of older women seeking fertility treatment. The existing evidence does not offer any clear-cut guidelines for the clinical handling of older women seeking fertility treatment. Various strategies have been tried to improve the fertility outcome of such women, but none has met with significant success. This review focuses on what can and what cannot be done in terms of improving fertility rates in older women.

Extracellular vesicles derived from endometrial human mesenchymal stem cells enhance embryo yield and quality in an aged murine model†

“…Advanced woman age is one of the most detrimental prognostic factors for fertility in humans as it decreases egg's competence. Nowadays, social, educational and financial pressures have delayed motherhood until the final thirties or forties, declining overall fertility and increasing the risk of miscarriage (1). When motherhood needs to be delayed, egg freezing is the assisted reproductive technique of choice to preserve the oocyte´s quality, but this has to be planned in advance which is not the most common scenario (2).…”

Extracellular vesicles derived from endometrial human mesenchymal stem cells improve IVF outcome in an aged murine model

“…Advanced woman age is a poor prognostic factor for fertility in humans as it decreases egg's competence and increases the risk of miscarriage (Rasool & Shah, ). This declined fertility has been linked to impaired reactive oxygen species (ROS) metabolism, mitochondrial dysfunction and apoptosis induction in the aged oocyte (Igarashi et al., ; Miao, Kikuchi, Sun, & Schatten, ; Mihalas, Redgrove, McLaughlin, & Nixon, ).…”