Ovarian ageing and fertility: Review

Declining fertility in women occurs as a result of ovarian ageing - a process associated with a reduction in the number and quality of oocytes. Knowledge of ovarian age is important at a time when many women tend to delay pregnancy and childbirth. As the natural history of ovarian ageing is unknown, it is difficult to predict, prevent or treat this phenomenon. The evaluation of ovarian reserve has been largely restricted to women undergoing assisted reproduction. Hence, the predictive value of some of the commonly used tests, in a general population of women is unknown. In this review we discuss the natural history and the potential causes of ovarian ageing. We also assess available methods of prediction and treatment of this condition including the use of techniques such as in vitro aturation and oocyte cryopreservation.