How old are your eggs?

Abstract

It is estimated that 10% of women experience a rapid decline in their ovarian reserve from the early 30s. This is called 'early ovarian ageing'. With the development of the so-called 'ovarian reserve tests', it was hoped that it would be possible to assess each woman's ovarian biological age and screen for 'early ovarian ageing' in the general population. This review examines the progress that has been made in this area. Almost the entire literature on ovarian reserve tests refers to women having IVF, rather than women in the general population. Recent systematic reviews have shown that the currently known 'ovarian reserve' tests are reasonably good at predicting the number of eggs that are collected following ovarian stimulation with gonadotrophins in the context of an IVF cycle. They show very poor correlation with live-birth rates. The reason is that they cannot directly assess oocyte quality. Screening for 'early ovarian ageing' in the general population is desirable but still not possible. Therefore, postponing childbearing to the late 30s remains a risky gamble. Advice to individual women should be given by specialist reproductive endocrinologists, though home-testing is not advisable.