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September 9, 1992

The New Frontier of Reproductive Age

Author Affiliations

From the Northeast Regional Center for Infertility & IVF, Beachwood, Ohio. Reprints not available.

JAMA. 1992;268(10):1320-1321. doi:10.1001/jama.1992.03490100118038

A female infant is born with a limited complement of ovarian oocytes. These oocytes are either ovulated or undergo atresia until menopause occurs when the complement of oocytes is exhausted. Although the average age for menopause in the United States is 51 years, menopause is generally preceded by a decade or more of declining reproductive capability, manifested by decreased cycle fecundity and increased rate of pregnancy loss. This decline is usually attributed to "aging" of the oocytes. While the Bible mentions pregnancy at advanced age,1 it is only relatively recently, with the combination of in vitro fertilization (IVF) and oocyte donation, that the means exist to establish pregnancies in women who would normally conceive infrequently, if at all.2

There are certainly legal, ethical, and pragmatic concerns associated with the use of donated oocytes in general. However, these concerns are limited when donated oocytes are used to establish pregnancies