Female Reproductive Aging

Preface: Reinier de Graaf and his symposium. Reinier de Graaf lecture: Reinier de Graaf and the discovery of the ovary. State-of-the- art lecture: Definition and character of reproductive aging and senescence. General aspects of reproductive aging and general aging: Why do women have a mid-life menopause? Grandmothering and the evolution of human longevity. Similarities between general and reproductive aging. Concepts in female reproductive aging. Postponement of childbearing and its effect on the prevalence of subfecundity. Physiology and endocrinology of reproductive aging: Mathematical models for follicle development and depletion. The endocrinology of ovarian (reproductive) aging in women. Ultrasound and ovarian reserve. Follicle development before and during the menstrual cycle. Age-dependent decline of female fecundity is caused by early fetal loss. Genetics and molecular biology of reproductive aging: Genetic parameters of oocyte aging. The determinants of non-disjuncti on and their possible relationship to oocyte aging. The control of mammalian female meiosis and the factors that influence chromosome segregation. The potential role of the oocyte in follicle development and ovarian aging. Mitochondrial dysfunction and ovarian aging. Transgenic animal models and ovarian function. Clinical aspects of reproductive aging: Premature ovarian failure. Clinical consequences of elevated follicle stimulating hormone levels in the patient treated for infertility. Oocyte quality versus endometrium quality in in vitro fertilization. Preimplantation assessment of human embryos from women of advanced age and patients with recurrent miscarriage. Index.