Age-related Decline In Female Fertility Research Articles

Assessing knowledge regarding fertility and attitude and intentions towards future parenthood among undergraduate medical students in Karachi

This study aimed to assess the knowledge regarding female fertility, infertility treatments and the attitudes regarding parenthood of medical students in Pakistan. Delayed childbirth among medical trainees due to extended years of medical education and training puts this population at a higher risk for involuntary childlessness later in life due to age-related decline in female fertility. A knowledge, attitude and practice study was carried out among medical students in Karachi in July 2021 using the English version of the Swedish Fertility Awareness questionnaire, which has been used in similar studies. Most participants wished to have children at some point in the future. However, a majority of students did not have sufficient knowledge regarding age-related decline in female fertility and overestimated the efficacy of infertility treatments. The results of this study indicate that despite planning to have children and placing great importance on parenthood, medical students severely overestimate female fertility and plan to start having children at an age at which female fecundity has begun to decline. These findings highlight a need for better provisions regarding fertility knowledge in the curriculum for medical students, as they are an at-risk group for involuntary childlessness due to age-related fertility decline.

O-091 From Family Planning to Fertility Planning - ‘FertPlan’ awareness amongst contraceptive healthcare providers and users

Abstract Study question Are women and healthcare professionals seeking or providing contraception aware of age-related decline in female fertility and information support regarding fertility awareness? Summary answer 89.9% of contraceptive users and 71% of providers stated lack of awareness regarding age and fertility emphasising website as the preferred information resource. What is known already The last 50 years has seen an upward trend in the age at which women are giving birth. The birth rate for women aged 35 to 39 has trebled since 1980 and is now at its highest ever level. Delaying childbearing may mean that some women will inevitably leave it too late and become childless involuntarily. Women are also seeking fertility treatment at older ages, however, success rates decrease dramatically with age. It is not clear whether women who delay their fertility are aware of the decline in fertility with age, and whether healthcare professionals discuss fertility planning with women. Study design, size, duration We conducted two independent anonymous questionnaire surveys of reproductive age women seeking contraception and healthcare professionals(HCP) providing contraception in the UK following research ethics approval, to determine their awareness of the age-related decline in fertility, information resource and potential barriers to provision of information. . This was a prospective study design conducted over a year period using an online questionnaire. A total of 249 participants completed the survey. Participants/materials, setting, methods 138 reproductive age women on contraception consented and participated in the study by completing the online questionnaire. Of these, 96.4% were of white origin,1.4% mixed ethnicity, 1.4% Asian origin and 0.7% Black. 111 HCP providing contraceptive advice in family planning clinics or in General practice completed the survey. Of these, 6 were allied healthcare professionals ie specialist nurses. Data was collated and analysed using percentages and descriptive statistics. Main results and the role of chance Of the total 138 female contraceptive users, 87 were aged 30-39 years whilst 35 were 40-45 years. 51.4% of women indicated no concern about their future fertility, whilst the remainder gave roughly uniformly distributed ratings of concern from unconcerned to highly concerned. However, one third of all women (31.1%) believed that age-related fertility decline occurred after 40 years. 89.9% of women felt fertility awareness and education is important. Of the total 111 HCP, ∼one in 10 HCP (11.7%) misconstrued the female age-related decline to begin from 40 years onwards. The contraceptive providers also were misinformed regarding age related decline in IVF success rate with 45% of them citing 40 years or over to be the age that contributed to decline in IVF success. Despite these figures, majority (71.2%) of HCP agreed there was lack of fertility awareness and 33.3% felt fertility education should be commenced as early as school age. 27% HCP always discussed future fertility whilst 33.3% discussed most of the times. The most commonly-stated barriers to providing information were lack of time, self-perceived lack of knowledge, and women not asking. 73.2% of reproductive age contraceptive users and 85.6% HCPs expressed website to be the most preferred option for information resource. Limitations, reasons for caution To the best of our knowledge, this is one of the first studies seeking fertility awareness amongst those practising family planning. As this was not a qualitative interview based study, the findings are open to interpretation and one must exercise caution. Wider implications of the findings This study highlights clear need for fertility education and awareness amongst contraceptive providers and users. By providing resources to inform, we may increase awareness and confidence amongst both groups thereby empowering women to make informed choices about their future fertility by integrating Fertility planning within Family Planning. Trial registration number Not applicable (IRAS 248991 and R&D Ref 8999)

P-401 The impact of the recipients’ age in vitrified/warmed oocyte donation (OD) cycles

Abstract Study question Does female age affect reproductive outcomes in a vitrified/warmed OD program with fresh embryo transfer? Summary answer Oocyte donation performed below the age of 40 was associated with less favorable reproductive outcomes. What is known already It is well established that oocyte and embryo aneuploidy are mainly responsible for the age-related decline in female fertility. Previous studies evaluating the effect of maternal age on implantation potential in OD cycles generated controversial results. It remains unclear whether female age affects reproductive outcome independent of embryo quality. Study design, size, duration This is a retrospective, single tertiary center, cohort study analyzing a vitrified/warmed OD program over a ten-years period (February 2010-February 2020). More specifically, data from 491 unique oocyte recipients were included who performed a fresh embryo transfer after sharing (with at least two recipients) sibling oocytes from the same donor stimulation cycle. For all treatments ICSI was performed without preimplantation genetic testing. Participants/materials, setting, methods The association between recipient’s age and reproductive outcomes was investigated according to three age categories (<35/35-40/>40 years old). The primary outcome was live birth rate (LBR), while the secondary outcome was biochemical pregnancy rate (BPR). A multivariate regression model was developed adjusting for the following covariates (entered simultaneously): recipient’s BMI, recipient’s endometrial thickness, age of the oocyte donor, number of mature oocytes used for ICSI, embryo transfer stage and number of embryos transferred. Main results and the role of chance Mean age of donors was 28.6 years old(±4.1). Mean starting dose was 192.6 IU(±139.9) and duration of stimulation 11.0 days (±1.7). Mean number of collected cumulus oocyte complexes was 25.6(±9.6) and sibling oocytes were assigned to 2, 3 or more recipients in, respectively, 83.1%, 12.4% and 4.5% of cases. Mean age of recipients was 38.6 years old(±5.1), BMI 24.3 kg/m²(±4.1) and endometrial thickness 8.9mm(±2.1). ICSI was performed on a mean number of 6.5 (±2.0) warmed, intact, mature oocytes with a fertilization rate of 68.2% (±22.5). Cleavage-stage embryos were transferred in 91.0% of the recipients, with a double embryo transfer in 42.6%. 81.3% of embryos were scored as top-quality and a mean of 1.4 (±1.4) surplus embryos were available for additional vitrification. Overall BPR was 44.2%, clinical pregnancy rate 39.3% and LBR 31.0%. Categorizing according to recipient’s age showed a LBR of 24.3%,26.7% and 37.0% for, respectively, the group <35, 35-40 and >40 years old (p = 0.02). The multivariate GEE regression model confirmed the crude data showing that the age was a significant positive predictor of LBR [coefficient (-), 0.01,0.11, for group<35,35-40 and >40 years old, p = 0.05] and BPR [coefficient (-),0.008,0.15, for group <35,35-40 and >40 years old, p = 0.006]. Limitations, reasons for caution Sibling donor oocytes were used, but the retrospective nature of the study remains a reason for caution. Also, the fact that the majority of embryos were transferred at the cleavage stage is a limitation. Wider implications of the findings The observation that recipients below the age of 40 have lower reproductive success rates following oocyte donation deserves further attention. The need for oocyte donation at younger age might be associated with a less performant uterine/endometrial function due to underlying conditions of genetic and/or endocrine nature. Trial registration number B1432020000146

Systematic Understanding of Anti-Aging Effect of Coenzyme Q10 on Oocyte Through a Network Pharmacology Approach.

BackgroundMaternal oocyte aging is strongly contributing to age-related decline in female fertility. Coenzyme Q10 (CoQ10) exerts positive effects in improving aging-related deterioration of oocyte quality, but the exact mechanism is unclear.ObjectiveTo reveal the system-level mechanism of CoQ10’s anti-aging effect on oocytes based on network pharmacology.MethodsThis study adopted a systems network pharmacology approach, including target identification, data integration, network and module construction, bioinformatics analysis, molecular docking, and molecular dynamics simulation.ResultA total of 27 potential therapeutic targets were screened out. Seven hub targets (PPARA, CAT, MAPK14, SQSTM1, HMOX1, GRB2, and GSR) were identified. Functional and pathway enrichment analysis indicated that these 27 putative targets exerted therapeutic effects on oocyte aging by regulating signaling pathways (e.g., PPAR, TNF, apoptosis, necroptosisn, prolactin, and MAPK signaling pathway), and are involved oxidation-reduction process, mitochondrion, enzyme binding, reactive oxygen species metabolic process, ATP binding, among others. In addition, five densely linked functional modules revealed the potential mechanisms of CoQ10 in improving aging-related deterioration of oocyte quality are closely related to antioxidant, mitochondrial function enhancement, autophagy, anti-apoptosis, and immune and endocrine system regulation. The molecular docking study reveals that seven hub targets have a good binding affinity towards CoQ10, and molecular dynamics simulation confirms the stability of the interaction between the hub targets and the CoQ10 ligand.ConclusionThis network pharmacology study revealed the multiple mechanisms involved in the anti-aging effect of CoQ10 on oocytes. The molecular docking and molecular dynamics simulation provide evidence that CoQ10 may act on these hub targets to fight against oocytes aging.

The Impact of Age Beyond Ploidy: Outcome Data From 8175 Euploid Single Embryo Transfers

(Abstracted from J Assist Reprod Genet 2020;37:595–602) Despite advances in the efficacy of assisted-reproductive technology (ART), age-related decline in female fertility remains robust with an approximate 4% live birth rate (LBR) in women older than 42. Although a clear correlation between advancing maternal age and increased rate of aneuploidy has been established, whether or not selection of euploid embryos in these women would mitigate the decline in age-related fertility remain unclear.

Autophagy in Female Fertility: A Role in Oxidative Stress and Aging.

Significance: The precipitous age-related decline in female fertility is intimately associated with a reduction in both the quantity and quality of the germline (oocytes). Although complex etiologies undoubtedly contribute to the deterioration of oocyte quality, increasing attention has focused on the pervasive impact of oxidative stress. Indeed, the prolonged lifespan of the meiotically arrested oocyte places this cell at heightened risk of oxidative lesions, which commonly manifest in dysregulation of protein homeostasis (proteostasis). Although oocytes are able to mitigate this threat via the mobilization of a sophisticated network of surveillance, repair, and proteolytic pathways, these defenses are themselves prone to age-related defects, reducing their capacity to eliminate oxidatively damaged proteins. Recent Advances: Here, we give consideration to the quality control mechanisms identified within the ovary that afford protection to the female germline. Our primary focus is to review recent advances in our understanding of the autophagy pathway and its contribution to promoting oocyte longevity and modulating pathophysiological responses to oxidative stress. In addition, we explore the therapeutic potential of emerging strategies to fortify autophagic activity. Critical Issues: The complex interplay of oxidative stress and autophagy has yet to be fully elucidated within the context of the aging oocyte and surrounding ovarian environment. Future Directions: Emerging evidence provides a strong impetus to resolve the causal link between autophagy and oxidative stress-driven pathologies in the aging oocyte. Such research may ultimately inform novel therapeutic strategies to combat the age-related loss of female fertility via fortification of intrinsic autophagic activity.

Insufficiency of melatonin in follicular fluid is a reversible cause for advanced maternal age-related aneuploidy in oocytes

Age-related decline in female fertility is a common feature that occurs in the fourth decade of women as a result of a reduction in both oocyte quality and quantity [1]. However, strategies to prevent the deterioration of maternal aged oocytes and relevant mechanisms are still underexplored. Here, we find that the reduced abundance of melatonin in the follicular fluid highly correlates with the advanced maternal age-related aneuploidy. Of note, we show that exposure of oocytes from aged mice both in vitro and in vivo to exogenous melatonin not only eliminates the accumulated reactive oxygen species-induced DNA damage and apoptosis, but also suppresses the occurrence of aneuploidy caused by spindle/chromosome defect that is frequently observed in aged oocytes. Importantly, we reveal that melatonin supplementation reverses the defective phenotypes in aged oocytes through a Sirt1/Sod2-dependent mechanism. Inhibition of Sirt1 activity abolishes the melatonin-mediated improvement of aged oocyte quality. Together our findings provide evidence that supplementation of melatonin is a feasible way to protect oocytes from advanced maternal age-related meiotic defects and aneuploidy, demonstrating the potential for improving the quality of oocytes from aged women and the efficiency of assisted reproductive technology.

Trends in Research on Adolescent Sexuality Education, Fertility Awareness, and the Possibility of Life Planning Based on Reproductive Health Education

In this paper, we describe the trends in research on adolescent sexuality education in Japan and other countries and on fertility awareness, as well as the possibility of life planning based on sex and reproductive health education. Mason-Jones AJ et al. reviewed the results of school-based intervention studies on the prevention of human immunodeficiency virus infection, sexually transmitted diseases, and pregnancy. There is little evidence supporting the idea that educational curriculum-based programs alone are effective in improving sex and reproductive health outcomes in adolescents. In another study, the effectiveness of school-based sexuality education for adolescents in Japan was evaluated. The Japan Medical Abstract Society was searched for articles published in the last 10 years. In many studies, the effects were compared before and after a single sexuality education lecture by professionals, such as doctors, midwives, and public health nurses. In Japan, effort has been directed toward sexuality education, but no systematic program based on behavior theory has been adopted. Therefore, sex education is insufficient. A third study clarified research on fertility awareness in adults and issues regarding improvements in related education and research. The Japan Medical Abstract Society and PubMed were searched for articles published in the last 10 years. The review suggested that awareness of female fertility is insufficient. Delaying childbearing based on inaccurate knowledge of the decline in female fertility could lead to unintended infertility. For males and females, sexual health education in schools and communities should include information on the age-related decline in female fertility. Although the determinants of the timing of childbearing are multifactorial, education on fertility issues is necessary to help adults make informed reproductive decisions based on accurate information. Finally, in this paper, we introduce examples of the pioneering efforts in sexual health education through collaboration between the governments of Oita and Okayama Prefectures and Oita and Okayama Universities.

Serbian medical students’ fertility awareness and attitudes towards future parenthood

Objectives: Medical students represent a group particularly at risk of involuntary childlessness due to their highly demanding careers and university curriculum. The aim of this study was to investigate Serbian medical students’ attitudes towards future parenthood and their awareness of fertility issues.Methods: A cross-sectional study was conducted among fourth year students at the Faculty of Medicine, University of Belgrade, Serbia, between 12 and 16 December 2016. Data were collected through an anonymous 56-item validated questionnaire, translated into the Serbian language. The participation rate was 87.1%.Results: More than 95% of students, regardless of gender, wanted to have children in the future; most indicated three as the desired number of children. Both genders equally rated the importance of having children. Women rated significantly higher the likelihood of IVF treatment or child adoption if faced with infertility (both p = .001). All students wanted to have their first child before the age of 35 years. Knowledge about the age-related decline in female fertility was not satisfactory. Women found it more important to have children when they felt sufficiently mature, were in a stable relationship, were financially secure, had completed their studies, were not too old to have children, and had access to childcare, although these prerequisites were rated highly by both genders.Conclusion: Serbian medical students greatly value and have a positive perception of future parenthood. Appropriate education is needed, however, because of their inadequate knowledge of the age-related decline in female fertility.

The role of oxidative stress in female infertility and in vitro fertilization.

Infertility problem involves many couples of reproductive age. It has been estimated that in Poland 0.7-1.0 million pairs require treatment, while for more than half of them assisted reproduction is the only recommended and effective method. Infertility affects 13 to 15% of the world's population. A major concern is the age-related decline in female fertility even more that often a decision about pregnancy is taken at later age. Recent studies show that increased production of reactive oxygen species is an important factor in etiopathogenesis of pregnancy and affects female reproduction. It was found that oxidative stress may damage the oocytes and may impair their fertilization capacity. Oxidative stress may also lead to embryo fragmentation and formation of numerous developmental abnormalities, and is regarded to be one of the important reasons of spontaneous and recurrent miscarriage. Moreover, overproduction of reactive oxygen species has a significant impact on the success of in vitro fertilization (IVF).

Fertility awareness and attitudes towards parenthood among Danishuniversity college students.

BackgroundPostponing parenthood has steadily increased during the past decades in Western countries. This trend has affected the size of families in the direction of fewer children born per couple. In addition, higher maternal age is associated with an increased risk of pregnancy-related complications such as prematurity and foetal death, while higher paternal age increases the risk of miscarriage and affects time-to-pregnancy. Hence, understanding the circumstances and reflections that influence the decision is greatly needed and little is known about potential gender difference influencing the choice. The aim was to investigate attitudes towards parenthood, intentions for childbirth and knowledge about fertility issues among men and women. MethodsWe conducted a cross-sectional study based on a validated 49-item questionnaire among students, who attended selected mandatory lectures at a Danish university college in February to April 2016. The participation rate was 99%, and 517 completed the questionnaire.ResultsThough the majority of all participants wished to have children in the future (>86%), there was significant difference between the genders (p = 0.002). Women rated having children to be more important than men did (p < 0.001), while men rated higher the likelihood of abstaining from having children if faced with infertility (p = 0.003). Knowledge about fertility issues was similar between genders including poor knowledge about the age-related decline in female fertility. While women found it more important to have children before being ‘too old’ (p = 0.04), still more than 40% of all respondents intended to have their last child after the age of 35 years. For both genders the most important prerequisite for parenthood was having a partner to share responsibility with. Perceived or experienced life changes related to parenthood were generally positive such as personal development.ConclusionThe majority of respondents wished to have children, but many desired to have these after the biological decline in female fertility. The moderate knowledge level among both genders uncovered in this study is of concern. Future research should address the potential link between fertility knowledge and planning of parenthood. We may benefit from intervention studies examining the effect of routine preconception care.

Fertility knowledge and the timing of first childbearing: a cross-sectional study in Japan

Although fertility educational initiatives have increased in developed countries to prevent infertility and to broaden fertility choices, the relationship between knowledge and behaviour is still poorly understood. In order to investigate the association between fertility knowledge and timing of childbearing, we investigated male and female participants between 35 and 44 years of age who had children (n = 640) from an online survey conducted in Japan in 2013. The age at which participants actually gave birth to or fathered their first child was compared between those who were aware for at least a decade of age-related decline in female fertility (hereinafter, those with past fertility knowledge) and those without. Age at first birth was significantly younger and more narrowly distributed among women with past fertility knowledge than among those without: 28.2 ± 3.4 vs. 29.8 ± 4.6 (mean ± SD). A multivariate linear regression analysis showed that women with past fertility knowledge gave birth to their first child 2.34 [95% confidence interval (CI): 1.09–3.59] years earlier compared to those without such knowledge. No significant relation existed among men. Being informed in young adulthood about the facts of fertility might be related to starting a family at an earlier age, although further longitudinal evaluation will be necessary.

Is Age-Related Decline in Female Fertility A Mitochondrial Dysfunction?

Is Age-Related Decline in Female Fertility A Mitochondrial Dysfunction?

Is Age-Related Decline in Female Fertility A Mitochondrial Dysfunction?

Is Age-Related Decline in Female Fertility A Mitochondrial Dysfunction?

DNA methylome and transcriptome sequencing in human ovarian granulosa cells links age-related changes in gene expression to gene body methylation and 3'-end GC density.

Diminished ovarian function occurs early and is a primary cause for age-related decline in female fertility; however, its underlying mechanism remains unclear. This study investigated the roles that genome and epigenome structure play in age-related changes in gene expression and ovarian function, using human ovarian granulosa cells as an experimental system. DNA methylomes were compared between two groups of women with distinct age-related differences in ovarian functions, using both Methylated DNA Capture followed by Next Generation Sequencing (MethylCap-seq) and Reduced Representation Bisulfite Sequencing (RRBS); their transcriptomes were investigated using mRNA-seq. Significant, non-random changes in transcriptome and DNA methylome features are observed in human ovarian granulosa cells as women age and their ovarian functions deteriorate. The strongest correlations between methylation and the age-related changes in gene expression are not confined to the promoter region; rather, high densities of hypomethylated CpG-rich regions spanning the gene body are preferentially associated with gene down-regulation. This association is further enhanced where CpG regions are localized near the 3'-end of the gene. Such features characterize several genes crucial in age-related decline in ovarian function, most notably the AMH (Anti-Müllerian Hormone) gene. The genome-wide correlation between the density of hypomethylated intragenic and 3'-end regions and gene expression suggests previously unexplored mechanisms linking epigenome structure to age-related physiology and pathology.

Diminished functional ovarian reserve is associated with dysbolism of amyloid precursor protein in granulosa cells

Diminished ovarian reserve is a primary cause of age-related decline in female fertility. However, its underlying mechanism remains unknown. Overexpression of amyloid precursor protein (APP ) in granulose cells (GCs) is related with ovarian aging have been demonstrated. This study detected APP, β-site APP-converting enzyme(BACE1),amyloid-β42(Aβ42) and apoptosis family members to further explore the impact of APP and its metabolites on ovarian.

The Kunming mouse: as a model for age-related decline in female fertility in human

To ascertain whether the Kunming (KM) mouse is an available model for age-related decline in female fertility in human or not, oocytes from young (6-8 weeks), middle-aged (9 months) and aged (12 months) female mice were compared with respect to number of oocytes, frequency of in-vitro maturation (IVM) and in-vitro fertilization (IVF), and meiotic chromosome segregation and alignment. The mean number of pups born per mouse decreased significantly from the young to the middle-aged and the aged mice. The mean number of ovarian follicles, ovarian germinal vesicle oocytes and ovulated MII oocytes decreased significantly with maternal age. The rate of IVM in oocytes from young mice (73.9%) was less significantly than that in oocytes from middle-aged and aged mice (86.1% and 84.4%, respectively). Immunocytochemical analysis showed that ageing caused a significantly higher rate (49.3%) of chromosome misalignment than that (15.7%) of the young mice. The presence of premature chromatids was also significantly higher in MII oocytes of aged mice as compared with young mice (37.8 versus 8.3%). Pronuclear formation was delayed in oocytes of middle-aged and aged females (35.5 and 42.3% respectively in 5 h of IVF) as compared with young mice (88.1%). The study suggests that KM mouse exhibits an age-related decline in female fertility. Significant reduction of germinal vesicle (GV) and MII oocytes and significant increase of metaphase chromosome misalignment and premature chromatid segregation after meiotic maturation of oocytes, similar to human, presumably contribute to the decline in aged KM mice.

Emergency IVF versus ovarian tissue cryopreservation: decision making in fertility preservation for female cancer patients

Hundreds of thousands of women in their reproductive years are diagnosed with cancer each year. As the number of female patients who survive cancer increases, the demand for effective and individualized fertility preservation options grows. Currently there are limited clinical options for fertility preservation, and the paucity of publications describing clinical experience and outcomes data has limited accessibility to these options. Decision making for patients diagnosed with cancer requires up-to-date knowledge of the efficacy and safety of available techniques. This article describes a step-by-step approach to evaluation of the cancer patient and presents an accumulation of clinical experience with challenges unique to patients with breast cancer and leukemia. Current data on reproductive outcomes of fertility preservation techniques are examined, demonstrating increasing evidence that these techniques are becoming effective enough to offer routinely to patients facing gonadotoxic cancer therapies, including those still considered to be "experimental."

XXI Nordic Fertility Society Meeting in Helsinki 6–8 August 2012

The Nordic Fertility Society (NFS) meeting, the 21st in a row, provides a good framework for following advances in the field of human reproduction. Over the years, our meetings have had a unique position in-between large international conferences, as a more intimate, clinically oriented event highlighting Nordic aspects in IVF. The scientific program included this year a broad range of various themes relevant to human reproduction and allied disciplines. The congress covered medical, psychological, sociological, nursing, laboratory and educational perspectives at a high level. Improving our daily practice will help us to bring greater satisfaction to our patients with fertility problems. We were pleased to have nearly 400 participants at the congress. There were 12 scientific sessions which presented updates on some of the hot issues in our field. The highly interesting, and controversial, topics of parenting and oocyte vitrification were covered in separate sessions, along with the preservation of fertility in women with severe chronic diseases, and the use of therapeutic agents which cause loss of fertility. The growing public awareness of the age-related decline in female fertility was discussed, as it seems likely that there will be more requests for fertility preservation for social reasons in years to come. Among the important presentations, we specifically note “Parenthood after IVF – the expectations in both women and men”, the “CoNARTaS project”, which is a large Nordic ART register of perinatal outcome in children born after cryopreservation, and sessions on “Stress and ART”, and “Legal limitations and ART”. Comprehensive registration of treatments provides tools to study ART results and especially long-term outcomes of IVF children and their families, and this has been a goal from the beginning of the NFS meetings. By sharing Nordic data and monitoring efficiency we can learn from each other and improve our success rates. It is estimated that a minimum of 340 000 IVF babies are being born in the world every year. The end of 2012 will be a global landmark, as cumulatively the total number of IVF babies born since Louise Brown in 1978 will reach 5 million. In the Nordic countries a summary of the IVF data for 2010 (collected by Karin Erb) stated that 12 146 IVF babies were born in that year – about 4.1% of all children born in the Nordic Countries (NFS web site http://www.nordicfs.org/). Meeting other colleagues and sharing experiences and opinions in a friendly atmosphere has always been an essential element of the Nordic meetings, along with contributions from the medical industry and the host city. The next NFS meeting will be in Haugesund, Norway, on 2–5 January 2014. NFS is working on a change of the society to become a federation of the four national societies. This will strengthen the relationship with the national fertility societies and give a better basis for creating and updating Nordic guidelines. Appendix S1. Abstracts from the congress available through the web-version of this report. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Diminished ovarian function is associated with distinctive DNA methylome changes in human ovarian granulosa cells

Diminished ovarian function is a primary cause for age-related decline in female fertility; however, its underlying mechanism remains unclear. This study investigated whether epigenetic mechanisms may underlie the ovarian aging process.