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Reproduction at Advanced Parental Age

  • Chapter
  • First Online:
Clinical Management of Infertility

Part of the book series: Reproductive Medicine for Clinicians ((REMECL,volume 2))

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Abstract

The aging of the human ovary and the depletion of the oocyte pool have traditionally been the marker of the ending fecundity. The availability of assisted reproduction and the associated technologies such as cryopreservation and egg donation has significantly extended the possibility to conceive quite far beyond the natural human fecundity. Such pregnancies in women of advanced age raise serious medical and ethical concerns regarding the welfare of both the mother and child. The adverse effect of advanced maternal age (AMA) on offspring health has been studied extensively and is currently well recognized. Here we will describe the dilemmas for setting up an age limit for conception attempts, how to screen the candidates in the narrow path of safety, and how to manage these pregnancies.

In contrast, the association between advanced paternal age (APA) and poor reproductive outcome has been less defined and studied, and its exact effect remained somewhat uncertain. In this chapter this issue will be reviewed including the relationship between APA and changes in testicular function, reproductive hormones, sperm parameters, sperm DNA fragmentation, telomere length, de novo autosomal dominant mutations and other genetic and epigenetic factors risks, childhood cancer, congenital anomalies, neurodevelopmental outcomes, and obstetrical complications.

The objective of this chapter is to raise the medical and ethical dilemmas associated with parenthood at advanced maternal and paternal ages and to try to answer some of them, at least from our specific social and medical setup perspective.

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Authors and Affiliations

  1. Infertility and IVF Unit, Beilinson Hospital RMC, Petah Tikva, Israel

    Eran Altman & Yoel Shufaro

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Eran Altman & Yoel Shufaro

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  1. Eran Altman
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  2. Yoel Shufaro
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Correspondence to Yoel Shufaro .

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Editors and Affiliations

  1. Department Obstetrics and Gynecology, Hebrew University, Jerusalem, Israel

    Joseph G. Schenker

  2. Department of Obstetrics and Gynecology, University of Pisa, Pisa, Italy

    Andrea R. Genazzani

  3. Department of Obstetrics and Gynecology, Northwestern Medical Faculty Foundation, Chicago, USA

    John J. Sciarra

  4. Obstetrics and Gynaecology, University Hospital Schleswig-Holst, Kiel, Germany

    Liselotte Mettler

  5. Department of Gynaecological, Endocrinology and Reproduction, University Hospital of Bern, Bern, Switzerland

    Martin H. Birkhaeuser

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Altman, E., Shufaro, Y. (2021). Reproduction at Advanced Parental Age. In: Schenker, J.G., Genazzani, A.R., Sciarra, J.J., Mettler, L., Birkhaeuser, M.H. (eds) Clinical Management of Infertility. Reproductive Medicine for Clinicians, vol 2. Springer, Cham. https://doi.org/10.1007/978-3-030-71838-1_3

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