Advanced Maternal Age in IVF: Still a Challenge? The Present and the Future of Its Treatment.
advanced maternal age
embryo selection
oocyte cryopreservation
oocyte donation
ovarian stimulation
single embryo transfer
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2019
2019
Historique:
received:
07
06
2018
accepted:
01
02
2019
entrez:
8
3
2019
pubmed:
8
3
2019
medline:
8
3
2019
Statut:
epublish
Résumé
Advanced maternal age (AMA; >35 year) is associated with a decline in both ovarian reserve and oocyte competence. At present, no remedies are available to counteract the aging-related fertility decay, however different therapeutic approaches can be offered to women older than 35 year undergoing IVF. This review summarizes the main current strategies proposed for the treatment of AMA: (i) oocyte cryopreservation to conduct fertility preservation for medical reasons or "social freezing" for non-medical reasons, (ii) personalized controlled ovarian stimulation to maximize the exploitation of the ovarian reserve in each patient, (iii) enhancement of embryo selection via blastocyst-stage preimplantation genetic testing for aneuploidies and frozen single embryo transfer, or (iv) oocyte donation in case of minimal/null residual chance of pregnancy. Future strategies and tools are in the pipeline that might minimize the risks of AMA through non-invasive approaches for embryo selection (e.g., molecular analyses of leftover products of IVF, such as spent culture media). These are yet challenging but potentially ground-breaking perspectives promising a lower clinical workload with a higher cost-effectiveness. We also reviewed emerging experimental therapeutic approaches to attempt at restoring maternal reproductive potential, e.g., spindle-chromosomal complex, pronuclear or mitochondrial transfer, and chromosome therapy.
Identifiants
pubmed: 30842755
doi: 10.3389/fendo.2019.00094
pmc: PMC6391863
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
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