Optimizing the Management of Fertility in Women over 40

209 Pages·2022·4.374 MB·English

by  Dimitrios S. Nikolaou, David B. Seifer

Optimizing the
Management of Fertility
in Women over 40

Optimizing the
Management of Fertility
in Women over 40
Edited by
Dimitrios S. Nikolaou
Chelsea&WestminsterHospital
David B. Seifer
YaleSchoolofMedicine
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Informationonthistitle:www.cambridge.org/9781316516829
DOI:10.1017/9781009025270
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DedicationforDimitriosS.Nikolaou:
ToEgbertteVede,MasoudAfnanandNikosKazantzakis
Tomyparents,SotiriosandKyriaki, withinfinitegratitude
fortheirsacrifices.
TomywifeDina,mycompanionandour2sons.
TomybrotherVassilis.
DedicationforDavidB.Seifer
“Maytheloveofmyartinspiremeatalltimes…”Maimonides
Tothememoryofmyparentsandtohonorthemembersofmy
family who have provided inspiration along my journey: my
mother,forherpassion,intellectualcuriosityandthepursuitof
knowledge; my father, for his mindset to challenge the norm
whilebeingrespectfulofothers;mybrotherforhisquestofa
physicalchallengeandhisembraceofthejoyoflife;mywifefor
hercommitmenttoexcellenceandhermoralcompass;andour
twowonderfulsonsforinspiringustobethebestversionsof
ourselvesandwhoareourlegacyforthefuture.

Contents
ListofContributors ix
Introduction 1 5 FertilityPreservationfor“Social”
Reasons 56
DimitriosS.NikolaouandDavid
TimothyBracewell-Milnesand
B.Seifer
DimitriosS.Nikolaou
Section 1 Demographic Trends Section 5 Optimal Deployment of
ART beyond 40
1 Is40theNew30?IncreasingReproductive
IntentionsandFertilityRatesbeyondAge
6 WhentoUseARTbeyond40:HowOften,
40 3 HowManyAttempts,WhentoStop 71
ÉvaBeaujouanandTomášSobotka
StevenD.SpandorferandPietro
Bortoletto
Section 2 Biological Basis of Female
7 OptimalIVFProtocolsforWomenover
Reproductive Aging: What Happens
40andLowFunctionalOvarianReserve 81
to the Ovaries and the Uterus as they DavidH.BaradandNorbertGleicher
Age? 8 FertilityCounselingbeyond40 98
AmirMorandDavidB.Seifer
2 BiologicalBasisofFemaleReproductive
Aging:WhatHappenstotheOvariesand 9 SupportSystemsandPatientExperience
UterusasTheyAge? 19 ArchitectureforFertilityCareofWomen
over40inthe2020s 106
JacquelynShaw,JenniferK.Blakemore,
andDavidL.Keefe DimitriosS.NikolaouandDavid
B.Seifer
Section 3 Lifestyle, Environment, and
Section 6 Obstetric Management
Optimizing Reproduction in the 40s
beyond 40
3 WhatLifestyleAdjustmentsCanMaximize
theChanceofaNaturalConceptionand 10 OptimalManagementoftheFirst
HealthyPregnancyinWomenover40? 27 TrimesterinWomenover40 119
AlexandraKermack BethCartwrightandAditiNaik
11 OptimalManagementofPregnancy
fi
Section 4 Rethinking and Rede ning beyond12Weeks,Labourandthe
“ ” PuerperiumforWomenover40 131
Family Planning for the Twenty-
ShaneDuffyandPrithaDasmahapatra
First Century
Section 7 Children of Older Parents
4 DiagnosticTestingofReproductive
Aging 39 12 WhatDoWeKnowabouttheChildrenof
TanyaL.GlennandDavidB.Seifer Womenover40andWhatCanOlder
vii
Contents
MothersDotoOptimizeTheirChildren’s PaulaAmatoandDimitriosS.
Development? 141 Nikolaou
WinifredMakandVickieSchafer
Section 10 Ethics
Section 8 What Are Realistic
15 EthicalIssuesintheUseofAssisted
Alternatives to Conceiving with
ReproductiveTechnologyinWomenover
Autologous Eggs? Age40 173
NicoleYoderandGwendolynP.Quinn
13 PracticalEggDonationinWomenover
Epilogue 180
40 153
JamesP.TonerandLaurenRouleau DavidB.SeiferandDimitrios
S.Nikolaou
Section 9 New Technologies
14 IsItLikelyThatReproductiveAgingCould
BeDelayedorReversedUsingAdvanced
TechnologiesintheFuture? 163 Index 181
viii
Contributors
PaulaAmato,MD ShaneDuffy,MBBS(Hons),DTM&H,DObst,
DMEd,MSc,FRCOG
DivisionofReproductiveEndocrinologyand
Infertility,DepartmentofObstetricsand Chelsea&WestminsterHospital,London,UK
GynecologyOregonHealth&ScienceUniversity,
NorbertGleicher,MD
Portland,Oregon,USA
TheCenterforHumanReproduction,NewYork,
DavidH.Barad,MD,MS
NY,USATheFoundationforReproductive
TheCenterforHumanReproduction,NewYork, Medicine,NewYork,NY,USAStemCellBiology
NY,USATheFoundationforReproductive andMolecularEmbryologyLaboratory,The
Medicine,NewYork,NY,USA RockefellerUniversity,NewYork,NY,USA
DepartmentofObstetricsandGynecology,
ÉvaBeaujouan
MedicalUniversityofVienna,Austria
WittgensteinCentreforDemographyandGlobal
TanyaL.Glenn,MD
HumanCapital(IIASA,OeAW),Universityof
Vienna,Vienna,Austria DivisionofReproductiveEndocrinologyand
Infertility,DepartmentofObstetrics,Gynecology,
JenniferK.Blakemore,MD,MSc
andReproductiveSciences,YaleSchoolof
LangoneFertilityCenter,NewYorkUniversity, Medicine,NewHaven,CT,USA
NewYork,NY,USA
DavidL.Keefe,MD
PietroBortoletto,MD
LangoneFertilityCenter,NewYorkUniversity,
TheRonaldO.PerelmanandClaudiaCohen NewYork,NY,USA
CenterforReproductiveMedicine,WeillCornell
AlexandraKermack
MedicalCollege,NewYork,NY,USA
NIHRClinicalLecturer/RegistrarObstetrics&
TimothyBracewell-Milnes
GynaecologySchoolofHumanDevelopmentand
AssistedConceptionUnit,Chelseaand HealthUniversityofSouthampton,UK
WestminsterNHSTrust,London,UK
WinifredMak,MD,PhD
BethCartwright
DellMedicalSchool,UniversityofTexasat
EarlyPregnancyUnit,ChelseaandWestminster Austin,TX,USA
Hospital,London,UK
AmirMor,MDPhD
PrithaDasmahapatra,MBBS(Calcutta
DivisionofReproductiveEndocrinologyand
University),MRCOG
Infertility,DepartmentofObstetrics,Gynecology,
Chelsea&WestminsterHospital,London, andReproductiveSciences,YaleUniversity
UK SchoolofMedicine,NewHaven,CT,USA
ix