Human Reproduction Update, Vol.8, No.2 pp.141-154, 2002
© European Society of Human Reproduction and Embryology 2002; all rights reserved
The variability of female reproductive ageing
1 Departments of Reproductive Medicine, University Medical Centre, Utrecht, 3508 GA, The Netherlands 2 Medical Genetics, University Medical Centre, Utrecht, 3508 GA, The Netherlands
To whom correspondence should be addressed at: Egbert R.te Velde, Department of Reproductive Medicine, University Medical Centre, Utrecht, 3508 GA, The Netherlands. e-mail: e.r.tevelde{at}azu.nl
Abstract
The delay in childbearing is an important societal change contributing to an increasing incidence of subfertility. The prevailing concept of female reproductive ageing assumes that the decline of both quantity and quality of the oocyte/follicle pool determines an age-dependent loss of female fertility. There is an apparent discrepancy between the ability to maintain a regular ovulatory cycle pattern and the several years earlier cessation of female fertility. This latter is largely explained by an age-related increase of meiotic non-disjunction leading to chromosomal aneuploidy and early pregnancy loss, such that most embryos from women 
40 years old are chromosomally abnormal and rarely develop further. The final stage of reproductive ageing–-the occurrence of menopause–-shows a huge variation between women. Age at last birth in natural fertility populations, which marks the end of female fertility, shows an identically wide variation as age at menopause, but occurs on average 10 years earlier. Given the high heritability for age at menopause, the variation in both age of menopause and last birth are probably under genetic control by the same set of genes. Some of those genes must carry heritable variants which modulate the rate of ovarian ageing and give rise to the wide age variations for the various phases of reproductive ageing.
Key words: age at last birth / age at menopause / delayed childbearing / genetic control / reproductive ageing
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