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Hanevik HI, Bergh C, Laivuori H, Spangmose AL, Magnusson Å, Pinborg A, Piltonen T. Limiting access to assisted reproductive technologies for males of advanced age-Pros and cons from a Nordic perspective. Acta Obstet Gynecol Scand 2024. [PMID: 39140140 DOI: 10.1111/aogs.14944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/29/2024] [Accepted: 07/28/2024] [Indexed: 08/15/2024]
Abstract
It is not controversial to state that parental age is increasing in several countries. But how to deal with this increase might be. Some Nordic countries have set an upper age limit for females seeking assisted reproduction in their national legislation, but none have done so for males. There are also recommendations in place that restrict access to publicly funded assisted reproduction for both females and males of advanced age in some Nordic countries. As recent data now show somatic and psychiatric health risks related to advanced paternal age, we ask if the time has come for countries to set an upper age limit for males seeking assisted reproduction like there already is for females, and summarize some of the risks and rewards involved in treating couples with advanced age in fertility clinics.
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Affiliation(s)
- Hans Ivar Hanevik
- Fertility Department Sor, Telemark Hospital Trust, Porsgrunn, Norway
- Centre for Fertility and Health, National Institute of Public Health, Oslo, Norway
| | - Christina Bergh
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hannele Laivuori
- Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, Tampere University Hospital, The Wellbeing Services, Tampere, Finland
- Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Anne Lærke Spangmose
- Fertility Clinic, Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Åsa Magnusson
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anja Pinborg
- Fertility Clinic, Department of Gynecology, Fertility and Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Terhi Piltonen
- Research Unit of Clinical Medicine, Department of Obstetrics and Gynecology, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
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Kocourková J, Šťastná A, Burcin B. The influence of the increasing use of assisted reproduction technologies on the recent growth in fertility in Czechia. Sci Rep 2023; 13:10854. [PMID: 37407590 DOI: 10.1038/s41598-023-37071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
This study aims to enhance the understanding of how the increasing use of assisted reproductive technologies (ART) has contributed to the increase in the total fertility rate (TFR) and to further delaying childbearing. Moreover, it addresses the gap in the methodology concerning the quantification of the effect of ART on fertility postponement. Czechia is one of few countries that are able to serve for the study of the demographic impacts of ART. ART and non-ART fertility rates were calculated using unique data on all children born in Czechia. Excluding mothers who received cross-border reproductive care, the proportion of ART live births in Czechia has not exceeded 4%. However, without ART the TFR would have stood at just 1.65 instead of 1.71 in 2020. ART significantly contributed to a reduction in childlessness and to the increase in fertility rates at ages over 35. Applying the decomposition method, the contribution of the use of ART to delaying childbearing between 2013 and 2020 was 4%. The findings have important policy implications. ART has the potential to support fertility recovery in the context of delayed childbearing. The findings served to alleviate concerns about the contribution of ART to the further undesired delay of childbearing.
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Affiliation(s)
- Jiřina Kocourková
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia
| | - Anna Šťastná
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia.
| | - Boris Burcin
- Department of Demography and Geodemography, Faculty of Science, Charles University, Prague, Czechia
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Šťastná A, Fait T, Kocourková J, Waldaufová E. Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:668. [PMID: 36612987 PMCID: PMC9819592 DOI: 10.3390/ijerph20010668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To investigate the association between a mother's age and the risk of caesarean section (CS) when controlling for health factors and selected sociodemographic characteristics. METHODS Binary logistic regression models for all women who gave birth in Czechia in 2018 (N = 111,749 mothers who gave birth to 113,234 children). RESULTS An increase in the age of a mother significantly increases the odds of a CS birth according to all of the models; depending on the model, OR: 1.62 (95% CI 1.54-1.71) to 1.84 (95% CI 1.70-1.99) for age group 35-39 and OR: 2.83 (95% CI 2.60-3.08) to 3.71 (95% CI 3.23-4.27) for age group 40+ compared to age group 25-29. This strong association between the age of a mother and the risk of CS is further reinforced for primiparas (probability of a CS: 11% for age category ≤ 19, 23% for age category 35-39, and 38% for age category 40+). However, the increasing educational attainment of young women appears to have weakened the influence of increasing maternal age on the overall share of CS births; depending on the model, OR: 0.86 (95% CI 0.80-0.91) to 0.87 (95% CI 0.83-0.91) for tertiary-educated compared to secondary-educated women. CONCLUSIONS The age of a mother comprises an independent risk factor for a CS birth when the influence of health, socioeconomic, and demographic characteristics is considered.
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Affiliation(s)
- Anna Šťastná
- Department of Demography and Geodemography, Faculty of Science, Charles University, 128 00 Praha, Czech Republic
| | - Tomáš Fait
- Department of Demography and Geodemography, Faculty of Science, Charles University, 128 00 Praha, Czech Republic
- Department of Gynaecology and Obstetrics, 2nd Faculty of Medicine, Charles University, 150 06 Praha, Czech Republic
- Department of Health Care Studies, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic
| | - Jiřina Kocourková
- Department of Demography and Geodemography, Faculty of Science, Charles University, 128 00 Praha, Czech Republic
| | - Eva Waldaufová
- Department of Demography and Geodemography, Faculty of Science, Charles University, 128 00 Praha, Czech Republic
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Zweifel JE, Woodward JT. The risky business of advanced paternal age: neurodevelopmental and psychosocial implications for children of older fathers. Fertil Steril 2022; 118:1013-1021. [PMID: 36347660 DOI: 10.1016/j.fertnstert.2022.10.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 11/08/2022]
Abstract
The last several decades are notable for an increase in the percentage of births attributable to men in their 40s and 50s. There is general recognition of offspring health risks related to advanced maternal age, however, fewer patients and providers are informed about the impacts of advanced paternal age (APA). This review examined the literature investigating the association between APA and offspring outcomes, specifically, neurodevelopmental, psychiatric, academic, and behavioral impairment, the impact of paternal health decline and death, and the influence of age on parenting behaviors. This analysis revealed that children, and even grandchildren, of older fathers face significantly increased incidence rates of psychiatric disease and behavioral impairment. The data do not show evidence of superior parenting behaviors among men with APA. Finally, children of men with APA are significantly more likely to experience early bereavement, which is associated with psychological and developmental consequences. An understanding of the degree to which APA can negatively impact the offspring is imperative for patient counseling and development of practice guidelines.
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Affiliation(s)
- Julianne E Zweifel
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA; Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
| | - Julia T Woodward
- Department of Psychiatry and Behavioral Sciences, Duke Fertility Center, Duke University Health System, Durham, North Carolina, USA; Department of Obstetrics and Gynecology, Duke Fertility Center, Duke University Health System, Durham, North Carolina, USA
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Bühler N. The making of 'old eggs': the science of reproductive ageing between fertility and anti-ageing technologies. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2022; 14:169-181. [PMID: 35024473 PMCID: PMC8732751 DOI: 10.1016/j.rbms.2021.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 05/09/2021] [Accepted: 07/29/2021] [Indexed: 06/14/2023]
Abstract
This article proposes going back in the history of reproductive medicine to shed light on the role of assisted reproductive technology (ART) in the making of 'old eggs'. Focusing on two key technologies - egg donation and cytoplasmic transfer - both of which contributed significantly to the production of scientific knowledge about reproductive ageing, the article suggests that ART can be analysed as 'in-vivo models' playing a pivotal role in the shift from age as a demographic variable to ageing understood in biological terms. It will shed light on the role of ART in locating age in the eggs and producing a cellular understanding of fertility decline. It argues that ART not only offers new means of reconfiguring the biological clock by extending fertility, but also reconfigures the biology of reproductive ageing itself. This becomes both the target and the means for new technological interventions, imaginaries and norms, anchored in women's bodies and a more plastic biology, and thereby illuminates hitherto underexplored aspects of the encounter between the science and technology of reproduction and anti-ageing.
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Couture V, Delisle S, Mercier A, Pennings G. The other face of advanced paternal age: a scoping review of its terminological, social, public health, psychological, ethical and regulatory aspects. Hum Reprod Update 2020; 27:305-323. [PMID: 33201989 DOI: 10.1093/humupd/dmaa046] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a global tendency for parents to conceive children later in life. The maternal dimension of the postponement transition has been thoroughly studied, but interest in the paternal side is more recent. For the moment, most literature reviews on the topic have focused on the consequences of advanced paternal age (APA) on fertility, pregnancy and the health of the child. OBJECTIVE AND RATIONALE The present review seeks to move the focus away from the biological and medical dimensions of APA and synthesise the knowledge of the other face of APA. SEARCH METHODS We used the scoping review methodology. Searches of interdisciplinary articles databases were performed with keywords pertaining to APA and its dimensions outside of biology and medicine. We included scientific articles, original research, essays, commentaries and editorials in the sample. The final sample of 177 documents was analysed with qualitative thematic analysis. OUTCOMES We identified six themes highlighting the interdisciplinary nature of APA research. The 'terminological aspects' highlight the lack of consensus on the definition of APA and the strategies developed to offer alternatives. The 'social aspects' focus on the postponement transition towards reproducing later in life and its cultural dimensions. The 'public health aspects' refer to attempts to analyse APA as a problem with wider health and economic implications. The 'psychological aspects' focus on the consequences of APA and older fatherhood on psychological characteristics of the child. The 'ethical aspects' reflect on issues of APA emerging at the intersection of parental autonomy, children's welfare and social responsibility. The 'regulatory aspects' group different suggestions to collectively approach the implications of APA. Our results show that the field of APA is still in the making and that evidence is lacking to fully address the issues of APA. The review suggests promising avenues of research such as introducing the voice of fathers of advanced age into the research agenda. WIDER IMPLICATIONS The results of this review will be useful for developing policies and preconception health interventions that consider and include prospective fathers of advanced age.
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Affiliation(s)
- Vincent Couture
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada.,Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Stéphane Delisle
- Research Center of the CHU de Québec-Université Laval, Québec G1L 3L5, Canada
| | - Alexis Mercier
- Faculty of Nursing, Université Laval, Québec G1V 0A6, Canada
| | - Guido Pennings
- Department of Philosophy and Moral Sciences, Bioethics Institute Ghent, Ghent University, Gent 9000, Belgium
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The realization of fertility intentions in the context of childbearing postponement: comparison of transitional and post-transitional populations. J Biosoc Sci 2020; 53:82-97. [DOI: 10.1017/s002193202000005x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractChildbearing postponement is a key demographic change that has been experienced by most European countries. It leads to a late-fertility pattern, with women realizing their reproductive plans preferentially after the age of 30. This may result in a lower fertility level. Since the ideal family size has not changed in most European countries, it has been argued that the end of the postponement transition further depends on the extent to which the lower fertility of younger women is compensated for by an increase in that of older women. Thus, the completion of the transition depends not only on the formation of a late childbearing pattern, but also on the capability of women to realize their reproductive plans if they commence childbearing later in their lives. This study employed a new approach to assess postponement transition based on analysis of the realization of the fertility intentions of women at later childbearing ages using survey panel data. A method that enables the differentiation between transitional and post-transitional cohorts was applied. The investigation was based on a comparison of the postponement transition in Czechia and France, the former being a post-communist and the latter a Western European country. It was found that despite having a similar pattern of fertility timing, Czechia and France underwent differing phases of postponement transition. The Czech population was identified as being transitional since only the ‘transition’ cohorts had completed their fertility during the period under study. These cohorts did not show a significant increase in realization of fertility intentions in later age. In contrast, the post-transitional French population is characterized by higher completed cohort fertility rates amongst women who entered motherhood at the age of 30 and over and by the significantly higher realization of fertility intentions for women aged 30–34 years.
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Zweifel JE, Woodward JT, Rebar RW, Sauer MV. Is it time to establish age restrictions in ART? J Assist Reprod Genet 2019; 37:257-262. [PMID: 31848898 DOI: 10.1007/s10815-019-01649-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/03/2019] [Indexed: 11/27/2022] Open
Abstract
Providers specializing in reproductive medicine are treating increasing numbers of women pursuing parenthood in their 40s, 50s, and beyond. The rise in later-life parenting can be linked to factors ranging from the advent of assisted reproductive technologies and donor oocytes to the highly publicized pregnancies of older celebrities. We explore the medical and psychosocial implications of this trend for both older parents and their children. We also discuss ethical arguments regarding older parents' access to fertility care, existing professional guidelines, and both public and provider opinions about setting age limits for fertility treatment. Finally, we share preliminary considerations of whether age policies should be established, applied to men as well as women, and standardized or considered on a case-by-case basis.
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Affiliation(s)
- Julianne E Zweifel
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, 2365 Deming Way, Middleton, WI, 53562, USA.
| | - Julia T Woodward
- Department of Psychiatry & Behavioral Sciences, Department of Obstetrics & Gynecology, Duke University Health System, Durham, USA
| | - Robert W Rebar
- Department of Obstetrics and Gynecology, Homer Stryker M.D. School of Medicine, Western Michigan University, Kalamazoo, MI, USA
| | - Mark V Sauer
- Department of Obstetrics, Gynecology & Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
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Lans C, Taylor-Swanson L, Westfall R. Herbal fertility treatments used in North America from colonial times to 1900, and their potential for improving the success rate of assisted reproductive technology. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 5:60-81. [PMID: 30023440 PMCID: PMC6047296 DOI: 10.1016/j.rbms.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 09/19/2016] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
This paper serves to fill a gap in the literature regarding evidence for the use of botanical remedies in the promotion of fertility. It examines the botanical remedies that were used in North America (1492-1900) for all stages of reproduction from preconception to birth, and discusses their potential for future use with present-day infertility treatments. Each medicinal plant discussed in this paper is assessed using an ethnomedicinal methodology that entails examining the published ethnobotanical, phytochemical and pharmacological data. A few clinical trials have shown that there is potential for medicinal plants to improve the success rate of assisted reproductive technology (ART) treatment if used in an integrated manner, similar to the integrated use of traditional Chinese medicine with ART treatment. For example, research has shown that older women who become pregnant have a high miscarriage rate, and this is one area that complementary and alternative medicines can address.
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Affiliation(s)
- Cheryl Lans
- Institute for Ethnobotany and Zoopharmacognosy, Beek, The Netherlands
| | - Lisa Taylor-Swanson
- College of Nursing University of Utah, Annette Cummings Building, 10 South 2000 East Salt Lake City, UT, USA
| | - Rachel Westfall
- Yukon Bureau of Statistics, Government of Yukon, Yukon, Canada
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Live birth rates are satisfactory following multiple IVF treatment cycles in poor prognosis patients. Reprod Biol 2016; 17:34-41. [PMID: 27964842 DOI: 10.1016/j.repbio.2016.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/22/2016] [Accepted: 11/28/2016] [Indexed: 11/22/2022]
Abstract
This seven-year retrospective study analysed the live birth rate (LBR) for women undergoing IVF treatment with various antral follicle counts (AFC). The LBR decreased with lower AFC ratings, and in 290 treatment cycles for women in the poorest AFC category, ≤4 follicles (group E), the LBR was the lowest at 10.7%. The pregnancy loss rate (PLR) significantly increased with poorer AFC categories, from 21.8% in AFC group A (≥20 follicles), to 54.4% in AFC group E (p<0.0001). This trend was repeated with advancing age, from 21.6% for younger women (<35years), to 32.9, 48.5 and 100% for ages 35-39, 40-44 and ≥45 years, respectively (p<0.0001). However, LBR within the specific AFC group E cohort was also age-dependent and decreased significantly from 30.0% for <35 years old, to 13.3, 3.9 and 0% for patients aged 35-39, 40-44 and ≥45 years, respectively. Most, importantly, LBR rates within these age groups were not dependent on the number of IVF attempts (1st, 2nd, 3rd or ≥4 cycles), which indicated that cycle number should not be the primary deciding factor for cessation of IVF treatment in responding women <45years old.
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Abstract
PURPOSE OF REVIEW Elective oocyte cryopreservation for deferred childbearing has gained popularity worldwide, commensurate with increased knowledge regarding age-related fertility decline. The purpose of this review is to summarize recent data regarding trends in delayed childbearing, review recent findings surrounding age-related fertility decline, acknowledge significant gaps in knowledge among patients and providers regarding fertility decline and review outcomes following elective oocyte cryopreservation. RECENT FINDINGS Despite an inevitable decline in fertility and increase in miscarriage with increasing female age, there is a growing worldwide trend to delay childbearing. Patients and providers alike demonstrate large gaps in knowledge surrounding age-related fertility decline. Oocyte cryopreservation is clinically approved for medically indicated fertility preservation, but a growing number of women are using oocyte cryopreservation to defer childbearing and maintain reproductive autonomy. Mounting data support the efficacy and safety of oocyte cryopreservation when used to electively defer childbearing, with recent studies demonstrating rates of euploidy, implantation and live birth rates equivalent to in-vitro fertilization (IVF) with fresh oocytes. SUMMARY Oocyte cryopreservation provides women with an option to defer childbearing and maintain reproductive autonomy, with IVF success rates on par with fresh IVF. However, it is critical that patients understand the limitations of oocyte cryopreservation. Greater education regarding age-related fertility decline should be geared toward patients and providers to prevent unintended childlessness.
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Affiliation(s)
- Kara N Goldman
- New York University Fertility Center (NYUFC), NYU Langone Medical Center, New York, New York, USA
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Gleicher N, Vega MV, Darmon SK, Weghofer A, Wu YG, Wang Q, Zhang L, Albertini DF, Barad DH, Kushnir VA. Live-birth rates in very poor prognosis patients, who are defined as poor responders under the Bologna criteria, with nonelective single embryo, two-embryo, and three or more embryos transferred. Fertil Steril 2015; 104:1435-41. [PMID: 26348275 DOI: 10.1016/j.fertnstert.2015.08.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 08/19/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine live-birth rates (LBRs) at various ages in very poor prognosis patients, who are defined as poor responders under the Bologna criteria. DESIGN Retrospective cohort study. SETTING Academically affiliated private fertility center. PATIENT(S) Among 483 patients, who under the Bologna criteria (three or fewer oocytes, >40 years of age, and/or antimüllerian hormone [AMH] <1.1 ng/mL [2/3 criteria minimum]) were poor responders, 278 (381 fresh IVF cycles) qualified for the study because they had at least one embryo on day 3 for transfer. INTERVENTION(S) IVF cycles in women with low functional ovarian reserve, involving androgen and CoQ10 supplementation and ovarian stimulation with daily gonadotropin dosages of 300-450 IU of FSH and 150 IU of hMG in microdose agonist cycles. MAIN OUTCOME MEASURE(S) Age-specific LBRs per ET. RESULT(S) Ages did not differ between nonelective (ne) single ET (SET), ne2-ET, and ne ≥ 3-ET cycles (41.3 ± 3.9, 41.7 ± 3.1, and 42.4 ± 2.1 years, respectively). Patients with neSETs demonstrated significantly lower AMH and higher FSH levels and required higher gonadotropin dosages than ne2-ET and ne ≥ 3-ET patients. LBRs declined with age. Above age 42, three or more embryos are required to achieve reasonable LBRs and two or more to avoid futility under American Society for Reproductive Medicine (ASRM) guidelines. CONCLUSION(S) Very poor prognosis patients can still achieve acceptable pregnancy rates at least till their mid-40s if they reach ET. The degree to which egg donation is emphasized as the only treatment option in such patients, therefore, requires reconsideration. Above age 42, at least two, and preferably three embryos, are however required to exceed futility, as defined by ASRM.
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Affiliation(s)
- Norbert Gleicher
- Center for Human Reproduction, New York, New York; Foundation for Reproductive Medicine, New York, New York; Stem Cell Biology and Molecular Embryology Laboratory, Rockefeller University, New York, New York.
| | - Mario V Vega
- Center for Human Reproduction, New York, New York; Department of Obstetrics and Gynecology, Mount Sinai St. Lukes-Roosevelt Hospital, New York, New York
| | | | - Andrea Weghofer
- Center for Human Reproduction, New York, New York; Vienna University School of Medicine, Vienna, Austria
| | - Yan-Guan Wu
- Center for Human Reproduction, New York, New York
| | - Qi Wang
- Center for Human Reproduction, New York, New York
| | - Lin Zhang
- Center for Human Reproduction, New York, New York
| | - David F Albertini
- Center for Human Reproduction, New York, New York; Department of Molecular and Integrative Physiology, University of Kansas School of Medicine, Wichita, Kansas
| | - David H Barad
- Center for Human Reproduction, New York, New York; Foundation for Reproductive Medicine, New York, New York; Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, New York
| | - Vitaly A Kushnir
- Center for Human Reproduction, New York, New York; Department of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, North Carolina
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14
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Epstein M, Zosmer A. The Limits of Reproductive Freedom: Advanced Maternal Age and Harm to the Unborn Child. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2015; 15:51-52. [PMID: 26575816 DOI: 10.1080/15265161.2015.1088985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
| | - Ariel Zosmer
- b Barts Health NHS Trust and Queen Mary University of London
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