Médecine de la Reproduction


Biological consequences of advanced maternal age in reproduction Volume 21, issue 3, Juillet-Août-Septembre 2019


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1 G.en.e.r.a. Umbria, GENERA. Center for Reproductive Medicine, Umbertide, Italy
2 Clinica Valle Giulia, GENERA Center for Reproductive Medicine, Rome, Italy
3 Dipartimento di Medicina Sperimentale, Università degli Studi di Roma “Sapienza”, Italy
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The average woman age at the first conception is increasing worldwide. The incidence of meiotic errors and chromosomal impairments in gametes and embryos increases with maternal aging. The consequent reduction in fecundity and fertility is then associated with a higher demand for Assisted Reproductive Technology (ART) to counteract such issue. In advanced maternal age (AMA) women, several reproductive insults are due to aging, encompassing reduced ovarian reserve, impaired oogenesis, altered follicular metabolism, compromised embryo competence, defective physiological pathways, epigenetic deregulation and lack of cell cycle checkpoints. In this review, we provide an overview of the most recent evidences and theories focused on maternal aging, outlining what is known about the putative biochemical and molecular mechanism underlying its inherent dysfunctions. We also briefly discuss the already established and the most promising future strategies designed to improve the management of AMA patients in IVF.

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