Ancient Chinese emperors sent messengers to the whole country and explored an elixir of life. Determent of aging has been an ultimate hope for humans for a long period. In the modern era, aging become a hot topic to be solved according to longevity. Equality of both sexes in society contributed to the late marriage and start of making children. There happen adverse effects to being conceived in the aged ovaries. The quality and quantity become impaired by the ovarian aging process. In the artificial reproductive treatment, the obtained number of oocytes in ovarian hyperstimulation diminishes in aged women. The aging impairs quality both in the nucleus and cytoplasm. Chromosomal and genetic abnormalities increase lower implantation and higher abortion. In aged women, PGT-A may be effective to effective treatment. On the other hand, aging affects organelles in the cytoplasm of oocytes by protein metabolic dysregulations. Especially it induces mitochondria dysfunction. Mitochondria are called a “powerhouse” and have an essential role in oogenesis and embryogenesis. There exist 200,000-40,000 mitochondria DNA copies in the mature oocytes. Mitochondria dysfunction causes maturation arrest of oocytes, fertilization failure, late cleavage, and fragmented embryos. We have two strategies to solve this problem by enhancement of mitochondrial function. One is the holistic approach. Reactive oxygen species (ROS) or free radicals impair mitochondrial function. Also, mitochondria themselves are known to produce ROS. We measure Diacron-Reactive Oxygen Metabolites (d-Rom) and biological antioxidant potential (BAP) that are predictors of systemic ROS level and antioxidant competence, respectively. Another method is a cell-engineering approach. We have conducted autologous mitochondria transfer into mature oocytes. The quality of the oocytes and embryos were dramatically improved by this method, and we obtained 13 healthy children.
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