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Women's Health Care Physicians
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Variations in practice may be warranted when, in the reasonable judgment of the treating clinician, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology. The American College of Obstetricians and Gynecologists reviews its publications regularly; however, its publications may not reflect the most recent evidence.
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The American College of Obstetricians and Gynecologists makes the following recommendations and conclusions:. A year-old woman presents for a well-woman visit. As part of your routine counseling, you discuss with her the effects of aging on fertility. She tells you she is not ready to become pregnant now but would like to become pregnant in the future.
She also mentions that her friend recently had a blood test done to "check her egg count, so she knows how much longer she can wait to have a baby. The number of oocytes in the ovaries reaches a maximum number typically 7—8 million at approximately 20 weeks of gestation. From that point onward, there is a rapid atresia of oocytes within the ovary.
By the age of puberty, there are approximately , oocytes remaining within both ovaries. Thus, the number of oocytes within the ovaries decreases with increasing age 1. Poor oocyte quality is characterized by a reduction in oocyte fertilization, subsequent embryo development, and embryo implantation. In addition, age-related reductions in oocyte quality lead to an increase in embryonic aneuploidy. After menopause defined as the final menstrual period resulting from the physiologic permanent decline in gonadal hormone levels confirmed by 12 months of amenorrhea in women with a uterus , there are few-to-no gonadotropin-responsive follicles contained within either ovary.
The data and recommendations in this Committee Opinion refer to women not seeking treatment for infertility.
Although the number of preantral and small antral follicles is fairly constant within a given menstrual cycle, these follicle numbers slowly decline with age. Moreover, there are currently no international assay standards 16— Thus, this information must be considered when interpreting the results of the test for an individual patient.
The ability to predict accurately the onset of menopause would provide important clinical knowledge. In October , the U. The test is "meant to be used only in conjunction with other clinical assessments and laboratory findings," and published peer-reviewed data on the accuracy and clinical performance of this specific test are not currently available For more information, including the U. Polycystic ovary syndrome is the most common endocrine disorder in women of childbearing age and a common cause of oligo-ovulation, hyperandrogenism, and infertility.
The ability to make an accurate diagnosis is important to address the metabolic and reproductive risks associated with the disorder Survival rates for reproductive-aged women with cancer have continued to improve over the years.
Appropriately, this has resulted in increased attention to the effects of gonadotoxic chemotherapy on long-term ovarian function and fertility potential There are no long-term data on births or fertility. Copyright by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, posted on the internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
American College of Obstetricians and Gynecologists. Obstet Gynecol ;e—9. Women's Health Care Physicians.
Case Study A year-old woman presents for a well-woman visit. Lifetime Ovarian Function and the Concept of Ovarian Reserve The number of oocytes in the ovaries reaches a maximum number typically 7—8 million at approximately 20 weeks of gestation. References Female age-related fertility decline.
Fertility preservation : Guidelines, reviews, statements, recommendations, standards
Committee Opinion No. Obstet Gynecol ;— BMC Med ;14 1 Tal R, Seifer DB. Ovarian reserve testing: a user's guide.
Related Infertility: A Clinician’s Guide to Diagnosis and Treatment
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