Reproduction at Advanced Parental Age

The aging of the human ovary and the depletion of the oocyte pool have traditionally been the marker of the ending fecundity. The availability of assisted reproduction and the associated technologies such as cryopreservation and egg donation has significantly extended the possibility to conceive quite far beyond the natural human fecundity. Such pregnancies in women of advanced age raise serious medical and ethical concerns regarding the welfare of both the mother and child. The adverse effect of advanced maternal age (AMA) on offspring health has been studied extensively and is currently well recognized. Here we will describe the dilemmas for setting up an age limit for conception attempts, how to screen the candidates in the narrow path of safety, and how to manage these pregnancies.