Abstract
Fertility rates in developed countries are declining. This is due to delayed childbearing which results in reduced fertility when the female tries for a child at an older age. The situation in Singapore is examined, as it is a good example of a developed country. Demographics show that marriages now occur later, and the first-born is to mothers who are becoming older. It is a biological fact that as the woman gets older, she is less fertile. With vitrification, it is now possible to cryopreserve these oocytes. This approach is now accepted by many medical organizations though there is a need to provide unbiased patient information so that she can make an informed decision. Possible down-sides to this strategy to ‘stop the clock’ (delay progression in age-related fertility decline) include elderly gravida and the accompanying obstetric problems. Another down-side to such a strategy will result in a large number of oocyte (egg) banks, and a large number of unclaimed oocytes. Elective oocyte cryopreservation is now legal in many developed countries in Europe, in North America and in Australasia.
Acknowledgment
The authors are grateful to Ms Bi Xiao Qiong, Jenny, for her encouragement in the writing of this review.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
Key issues
• There is a gradual decline in fertility rates especially in developed countries.
• This is due mainly to delayed parenthood, especially for the first-born child.
• Such a delay means shifting the curve to the right as there is a biological decline in fertility with increasing age.
• Can oocytes be collected and cryopreserved when the female is at a younger age to preserve their reproductive potential thus preventing this biological decline in fertility?
• Vitrification is now a safe and efficient technique to cryopreserve human oocytes.
• Is it unethical not to offer this service to females who choose to delay parenthood?
• Biological decline in fertility with increasing age should be considered a medical problem.