Akademik Veri Yönetim Sistemi
Jinekoloji ve Obstetri Bulteni, cilt.6, sa.3, ss.118-127, 1997 (Scopus)
Currently most of the women in developed countries postpone their first pregnancies to late reproductive periods. When decrease in fertility with increased age is taken into account, infertility becomes a significant problem in these periods. Ovarian dysfunction is reported to be the main responsible factor for the decrease in fertility in advanced age. The age of the women is an important indicator showing the status of ovarian reserve, however, if is not capable to predict the prognosis of fertility alone. For this reason, obtaining basal level of FSH, clomiphene citrate challenge test and GnRH analogue stimulation test, developed for evaluation of the ovarian reserve, are used for infertility work up of women with advanced age, especially of those who are candidates for assisted reproductive techniques. Various new treatment methods are suggested in order to increase the success rates of these techniques for those, who were shown to have insufficient ovarian reserves by these tests and/or who have poor responses to the standard ovarian stimulation methods. Although fertilization can be achieved by assisted reproductive techniques, early embryo losses create a significant problem in women with advanced age. Chromosomal abnormalities and suboptimal laboratory conditions are thought to be responsible for most of these losses. For this reason, blastomer biopsies during preimplantation period and assisted hatching techniques are advised for these women. Despite these problems, even it live pregnancies can be achieved, perinatal mortality and morbidity rates are usually high due to the increased rate of pregnancy complications and systemic maternal diseases in advanced age.