Late maternity: natural fertility and ART
Nina Rusanova, Russian Academy of Science
Late maternity means fertility for women >35 but this group is assorted. According to WHO determination age of 35-44 - late reproduction, 45-49 – premenopause, >49 - postreproduction (menopause). Different physiological abilities of fecundity imply that normal natural fertility begins to reduce to subfertility or infertility for women >35 and pregnancy with own oocytes is impossible for women >45, they need special ART programs. Russia 1999-2006: investigation of quantity and quality of late maternity. Data base: data of Russian Federal State Statistic Service, statistic of ESHRE (European Society of Human Reproduction and Embryology, European IVF Monitoring), ASRM (American Society of Reproductive Medicine), IFFS (International Federation of Fertility Societies, Survelliance-2004, 2007), RAHR (Russian Association of Human Reproduction, ART monitoring), investigation of patients of Scientific Center of Obstetrics, Gynecology and Perinatalogy (Russian Academy of Medical Sciences, Moscow, 1999-2006). Russian reproductive legislation virtually doesn’t limit women’s age for ART and doesn’t forbid any one. Generally it speaks about “child-bearing age” which is treated individually, only reproductive donation and surrogacy have concrete limitation (age of 20-35). Under the conditions of paid reproductive medicine accessibility of ART depends on their cost and share of patients elder 35 differentiates in ART programs: 30-40% in IVF and ICSI, 60-70% in oocyte donation (2003). Characteristics of pregnancies of patients elder 45 is that success of treatment depends not so much on modification of ART schemas as individual ovarial reserve. Oocyte donation creates additional moral problems but duplicates possibility of pregnancy for them (2006). In spite of growth of late fertility in Russia in 1999-2006 it can’t significant enlarge total number of births but can influence positive on life quality.