Effect of aging on the female reproductive system: evidence for a role of uterine senescence in the decline in female fecundity
Cano, F.; Simón, C.; Remohí, J.; Pellicer, A.
Fertility and Sterility 64(3): 584-589
1995
ISSN/ISBN: 0015-0282 PMID: 7543864 DOI: 10.1016/s0015-0282(16)57797-8Document Number: 415056
Objective: To determine the effects of age on reproductive performance of women using oocyte donation as an in vivo model. Setting: Oocyte donation and IVF programs at the Instituto Valenciano de Infertilidad. Patients: Seventy-six women undergoing 90 cycles of ovum donation, who were recipients of 36 donors undergoing IVF, and 9 fertile women. Design: Prospective longitudinal study: (1) recipients underwent an artificial cycle to demonstrate adequate response of the endometrium to exogenous steroids; (2) oocytes from the same cohort of follicles were distributed randomly into recipients younger and older than 40 years; and (3) pregnancies were followed during the first trimester. Main Outcome Measures: Endometrial histology, fertilization, embryo quality, pregnancy, implantation, and abortion rates in both groups of recipients. Serum E-2, P and beta-hCG levels during initial pregnancy. Results: Similar implantation rates but significantly higher abortion rates were detected in women gt 40 years despite an appropriate action of P on the endometrium and the transfer of embryos in similar number and quality. The secretion of E-2 and P by the placenta started earlier in pregnancies included in the group lt 40 years. Conclusions: Age increases pregnancy losses in ovum donation patients after implantation is completed. This is accompanied by a retardation of steroid synthesis and suggests that the mechanisms responsible for placenta formation and functioning in the uterus is affected by age. Thus, uterine aging also is a factor influencing the poor reproductive performance of women with advancing age.