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State of the art in assisted reproductive technologies for patients with advanced maternal age

Published online by Cambridge University Press:  22 February 2023

Taisiia Yurchuk Open the ORCID record for Taisiia Yurchuk [Opens in a new window] ,
Marina Petrushko  and
Barry Fuller
Taisiia Yurchuk*
Affiliation:
Institute for Problems of Cryobiology and Cryomedicine (IPC&C) of the National Academy of Sciences of Ukraine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair in Cryobiology, Kharkiv, Ukraine
Marina Petrushko
Affiliation:
Institute for Problems of Cryobiology and Cryomedicine (IPC&C) of the National Academy of Sciences of Ukraine and United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair in Cryobiology, Kharkiv, Ukraine ART-Clinic of Reproductive Medicine’, Kharkiv, Ukraine
Barry Fuller
Affiliation:
University College London Division of Surgery and Interventional Science, Royal Free London National Health Service Trust, Royal Free Campus, London, UK
*
Author for correspondence: Taisiia Yurchuk. Taisiia Yurchuk, 23 Pereyaslavska St., Kharkiv, Ukraine 61016. E-mail: taisiya.yur@gmail.com
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Summary

According to the World Health Organization, the female reproductive age lasts up to 49 years, but problems with the realization of women’s reproductive rights may arise much earlier. Significant numbers of factors affect the state of reproductive health: socioeconomic, ecological, lifestyle features, the level of medical literacy, and the state of the organization and medical care quality. Among the reasons for fertility decline in advanced reproductive age are the loss of cellular receptors for gonadotropins, an increase in the threshold of sensitivity of the hypothalamic-pituitary system to the action of hormones and their metabolites, and many others. Furthermore, negative changes accumulate in the oocyte genome, reducing the possibility of fertilization, normal development and implantation of the embryo and healthy offspring birth. Another theory of ageing causing changes in oocytes is the mitochondrial free radical theory of ageing. Taking into account all these age-related changes in gametogenesis, this review considers modern technologies aimed at the preservation and realization of female fertility. Among the existing approaches, two main ones can be distinguished: methods allowing the preservation of reproductive cells at a younger age using ART intervention and cryobanking, as well as methods aimed at improving the basic functional state of advanced-age women’s oocytes and embryos.

Keywords

Advanced-age womenAssisted reproductive technologiesFertility preservationMitochondrial donationOocytePlatelet-rich plasma
Type
Review Article
Information
Zygote , Volume 31 , Issue 2 , April 2023 , pp. 149 - 156
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Copyright
© Institute for Problems of Cryobiology and Cryomedicine National Academy of Sciences of Ukraine, 2023. Published by Cambridge University Press

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