JAMA Clinical Reviews cover image

JAMA Clinical Reviews

Ovarian Aging

Nov 26, 2024
In this insightful discussion, OBGYN and fertility specialist Albert L. Hsu, an associate professor at the University of Cincinnati, addresses the critical issue of ovarian aging and its impact on fertility. He explores the decline in fertility rates among women over 35 and the biological factors at play, including mitochondrial defects. Hsu emphasizes the importance of educating women about their reproductive health and discusses proactive strategies like egg freezing to enhance future pregnancy chances.
13:50

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Quick takeaways

  • Ovarian aging significantly impacts fertility in women over 35, with declining function leading to reduced success rates in treatments.
  • Egg freezing offers a viable strategy for women to preserve fertility, enhancing chances of future successful pregnancies when done at a younger age.

Deep dives

Declining Fertility Rates and Age of First Birth

Fertility rates in the United States have seen a significant decline, dropping from approximately 71 births per 1,000 women in 1990 to 56 in 2022. The age at which women have their first child has also increased, with the average age rising from 27 in 1990 to 30 in 2019. Contributing factors to this trend include economic concerns, work commitments, and insufficient support systems for pregnancy and child-rearing. As women opt to postpone childbearing, understanding the implications of ovarian aging on fertility becomes vital to address these societal shifts.

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