Being a good egg in the 21st century

INTRODUCTION: Women are increasingly having children at a later age, but this can conflict with declining fertility in the later 30′s and thereafter. AREAS OF AGREEMENT: Declining egg quality and quantity with age are well-established, although egg quality can only be surmised from reproductive success or failure. AREAS OF CONTROVERSY: Whether increasing the number of eggs that can be obtained from ovarian stimulation is of value, and whether there are precursor cells within the adult ovary that could become mature eggs. GROWING POINTS: There is increasing use of donated eggs by older women to enhance their chances of conception. The storage of frozen eggs for potential use later in life is also becoming more common. AREAS TIMELY FOR DEVELOPING RESEARCH: Understanding of growth initiation of follicles and development of an artificial ovary may lead to the ability to affect fertility and reproductive lifespan.