How Old is Too Old? Age, Genetics and Reproduction. Marcelle I. Cedars, M.D. Director, Division of Reproductive Endocrinology UCSF. What is Reproductive Aging?. Quantity: Natural process of oocyte loss Fourth month of fetal development 6-7 million Birth 1-2 million Menarche 400,000
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Marcelle I. Cedars, M.D.
Director, Division of Reproductive Endocrinology
Gougeon, Maturitas, 30:137-142, 1998
AFC = 18
Chance of conception
Determine the time before
ovarian aging begins
Chance of conception, with or without treatment
Optimal dose or protocol for treatment
Maheshwari, et al, 2006
Markers of ovarian reserve, such as basal AMH or FSH levels and AFCs, can predict quantity of oocytes, but are not good predictors of oocyte quality (defined as pregnancy success).
PR = 46.7
IR = 28.4
PR = 28.7
IR = 15.9
10 20 30 40
Balasch et al., 2006
2.5mg over 5 days