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Reproductive potential in the older woman.

Abstract

There is a definite increase in the number of women bearing children in the 30- and 40-year-old age groups. The total number of women who are 35 to 40 years of age in the United States is projected to increase 42% and the percent births to this age group is projected to increase 37%. This is apparently because of a trend to postpone childbearing and first birth due to women's career priorities, advanced education, control over fertility, financial concerns, late and second marriages, and infertility. Associated with this is an increase in visits to the infertility specialist for older women who have an intrinsic decrease in fecundity with advancing age. Although, on the average, a woman will not experience menopause until about 50 years of age, her effective childbearing period may stop almost a decade earlier. A woman in her late 30s and, especially, early 40s is at some disadvantage in terms of conception delay, ability to carry a chromosomally normal fetus until term, and risk of trisomic conception. Certain endocrinologic parameters have been identified for the woman entering the transition to menopause. Biologic aging of the hypothalamic-pituitary-ovarian axis is intertwined with changes in the endocrine milieu of the perimenopause and preperimenopause. Despite a clear association of decreased fecundity in older women due to multiple biologic and social influences, so long as the individual has regular cycles and essentially normal endocrine parameters, she should be a candidate for an expedited infertility workup and ovulation induction, if not more aggressive treatment. Her obstetric profile is much improved, except for an increase in congenital anomalies and chromosomal defects. Chorionic villus biopsy study or amniocentesis is advised in all cases, regardless of therapy.

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    Fertility and sterility 46:6 1986 Dec pg 989-1001

    MeSH

    Abortion, Spontaneous
    Adolescent
    Adult
    Age Factors
    Animals
    Chromosome Aberrations
    Chromosome Disorders
    Female
    Fertility
    Humans
    Infant, Newborn
    Infertility, Female
    Maternal Age
    Menopause
    Menstrual Cycle
    Middle Aged
    Pregnancy
    Pregnancy Complications
    Pregnancy, High-Risk
    Rats
    Reproduction

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    3536609

    Citation

    Gindoff, P R., and R Jewelewicz. "Reproductive Potential in the Older Woman." Fertility and Sterility, vol. 46, no. 6, 1986, pp. 989-1001.
    Gindoff PR, Jewelewicz R. Reproductive potential in the older woman. Fertil Steril. 1986;46(6):989-1001.
    Gindoff, P. R., & Jewelewicz, R. (1986). Reproductive potential in the older woman. Fertility and Sterility, 46(6), pp. 989-1001.
    Gindoff PR, Jewelewicz R. Reproductive Potential in the Older Woman. Fertil Steril. 1986;46(6):989-1001. PubMed PMID: 3536609.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Reproductive potential in the older woman. AU - Gindoff,P R, AU - Jewelewicz,R, PY - 1986/12/1/pubmed PY - 1986/12/1/medline PY - 1986/12/1/entrez KW - Abortion, Spontaneous KW - Age Factors--women KW - Animals, Laboratory KW - Biological Aging KW - Biology KW - Clinical Research KW - Contraceptive Usage KW - Demographic Factors KW - Economic Factors KW - Endocrine Effects KW - Endocrine System KW - Fecundability KW - Fecundity KW - Fertility KW - Fertilization KW - Follicle Stimulating Hormone KW - Genetics KW - Gonadotropins KW - Gonadotropins, Pituitary KW - Hormones KW - Literature Review KW - Luteinizing Hormone KW - Macroeconomic Factors KW - Maternal Age KW - Menopause KW - Ovulation KW - Parental Age KW - Physiology KW - Population KW - Population Characteristics KW - Population Dynamics KW - Pregnancy Complications KW - Reproduction KW - Reproductive Behavior KW - Reproductive Control Agents KW - Research And Development KW - Research Methodology KW - Sex Behavior KW - Socioeconomic Factors KW - Technology KW - Treatment SP - 989 EP - 1001 JF - Fertility and sterility JO - Fertil. Steril. VL - 46 IS - 6 N2 - There is a definite increase in the number of women bearing children in the 30- and 40-year-old age groups. The total number of women who are 35 to 40 years of age in the United States is projected to increase 42% and the percent births to this age group is projected to increase 37%. This is apparently because of a trend to postpone childbearing and first birth due to women's career priorities, advanced education, control over fertility, financial concerns, late and second marriages, and infertility. Associated with this is an increase in visits to the infertility specialist for older women who have an intrinsic decrease in fecundity with advancing age. Although, on the average, a woman will not experience menopause until about 50 years of age, her effective childbearing period may stop almost a decade earlier. A woman in her late 30s and, especially, early 40s is at some disadvantage in terms of conception delay, ability to carry a chromosomally normal fetus until term, and risk of trisomic conception. Certain endocrinologic parameters have been identified for the woman entering the transition to menopause. Biologic aging of the hypothalamic-pituitary-ovarian axis is intertwined with changes in the endocrine milieu of the perimenopause and preperimenopause. Despite a clear association of decreased fecundity in older women due to multiple biologic and social influences, so long as the individual has regular cycles and essentially normal endocrine parameters, she should be a candidate for an expedited infertility workup and ovulation induction, if not more aggressive treatment. Her obstetric profile is much improved, except for an increase in congenital anomalies and chromosomal defects. Chorionic villus biopsy study or amniocentesis is advised in all cases, regardless of therapy. SN - 0015-0282 UR - https://www.unboundmedicine.com/medline/citation/3536609/Reproductive_potential_in_the_older_woman_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(16)49869-9 DB - PRIME DP - Unbound Medicine ER -