Ovarian Aging & Reproductive Longevity [Reproductive Health Report]

Men and women experience aging differently - physically and socially. For example, generally speaking (which can be dangerous, but often necessary), when it comes to aging, testosterone begins to decline earlier in men but at a more gradual rate, while estrogen levels more rapidly decline at a later age in women. This quicker decline in hormone levels is one of the primary drivers that diverges the aging trajectories of men and women that also ties into many other physical and social components – but particularly reproductive aging.

Reproductive aging focuses on the aging processes specific to the female reproductive system and fertility, which have been shown to profoundly impact overall health (including physical, emotional, social, etc.). On the other hand, reproductive longevity promotes multiple pillars of female health and wellness by targeting the underlying processes of reproductive aging. There has been some amazing research in the field, and this 1Pager aims to highlight the need for future advances in reproductive health and aging in parallel to the AthenaDAO Reproductive Health Report.

?Since the mid-1970s, the average age of childbearing has steadily increased. Approximately 18% of all United States (US) births in 2018 were to women 35 years and older, which is by most measures categorized as advanced maternal age (AMA). Furthermore, in line with most high-income countries, the average age of first birth has increased for all race and ethnicity groups across all 50 states in the US. This trend is expected to continue as unplanned pregnancies decline with long-term and effective contraception and as women and couples increasingly opt to defer pregnancy for various financial, social, professional, and personal considerations.

Sometimes in their mid-thirties or early forties, women typically experience a decline in fertility, coupled with a pronounced increase in the risk of Trisomy 21/Down Syndrome (and other chromosomal irregularities), miscarriage, and congenital abnormalities. In particular, the incidence of chromosome abnormalities increases from approximately 2% for women in their twenties to 35% and 50% for women in their forties and fifties, respectively. The combination of these social and molecular phenomena has resulted in an increased demand for assisted reproductive technology (ART) services, including the extraction, preservation, and fertilization of oocytes.

The motivation for oocyte cryopreservation (egg freezing) may vary and be multifaceted. More common reasons include oocyte donation, medical freezing (women undergoing toxic therapies, endometriosis, etc., which may impair fertility), oocyte freezing among transgender people (in case of female-to-male transition), and “social freezing,” which allows women to defer childbearing and preserve fertility for other reasons in anticipation for age-related decline in oocytes. Because of the high cost and elective nature of most indications, which may or may not be covered by health insurance plans. In the latter case, methods can be cost-prohibitive and inaccessible to those of lower or middle socioeconomic status.

Therefore, new strategies for oocyte preservation and rejuvenation may help reshape the therapeutic landscape and alleviate treatment gaps and disparities in fertility health and resources.

AthenaDAO is a decentralized autonomous organization (DAO) of researchers, funders, and advocates working to advance women’s health research, education, and funding. "Decentralized," meaning that it is not under the control of any single individual or entity. Instead, it is managed by its members and distributed around the world. AthenaDAO primarily funds translational research and the development of therapeutics, diagnostics, devices, and other innovations aiming to serve this traditionally underfunded area. It is particularly interested in transformational contributions to women’s health.?