Reversing the natural decline in human fertility: An extended clinical trial of oocyte donation to women of advanced reproductive age

Primary Ovarian Insufficiency

“…For couples who decide to pursue parenthood actively, the options are adoption, foster parenthood, egg donation, and embryo donation; ovarian transplantation has been performed in rare cases in which the patient has an identical twin with normal ovarian function 46. There is no medical urgency to proceed to egg donation, because the rates of pregnancy with egg donation appear to be similar among older and younger women 47. Women with primary ovarian insufficiency who become pregnant as a result of oocyte donation may have an increased risk of delivering infants who are small for gestational age and of having pregnancy-induced hypertension and postpartum hemorrhage,48–50 but these findings are controversial.…”

Germline Energetics, Aging, and Female Infertility

“…Thus, the beneficial effects of DR on female fertility, fecundity and offspring survival are apparently not due to maintenance of a larger follicle reserve with age. While it is conceivable that the benefits of DR in this model are partly a result of improved capacity of the uterus of aged females to establish and support a pregnancy, oocyte donation studies in humans have demonstrated that aging-related infertility can be effectively overcome by use of oocytes from young adult donors (Klein and Sauer, 2002; Sauer et al, 1992). In fact, given that women in their sixties have successfully carried pregnancies to term as surrogates (Paulson et al, 2002; Sauer et al, 1995), the single most important factor for determining pregnancy success rates in women of advanced maternal age seems to be oocyte quality and not uterine dysfunction (Navot et al, 1991).…”

Infertility and Early Pregnancy Loss Is Largely Due to Oocyte Aging, Not Uterine Senescence, as Demonstrated by Oocyte Donation

“…More importantly, when embryos provided through the in vitro fertilization of oocytes denoted by younger women (aged 21–34 years) are transferred to older women, implantation rates, miscarriage rates, and live birth rates are comparable regardless of age (T 6). 41–46 This contrasts with rates for each of these parameters when older infertile women undertake similar procedures using their own gametes.…”