The Impact of Age on Oocyte Quality and Reproductive Potential

Abstract

Maternal aging significantly impacts female fertility by diminishing both the quantity and quality of oocytes. This review examines the physiological, cellular and molecular mechanisms underlying age-related oocyte decline and its implications for reproductive potential. Ovarian aging accelerates after the mid-30s, resulting in increased aneuploidy, mitochondrial dysfunction, epigenetic alterations and telomere attrition. These cause impaired competence of oocytes, resulting in decreased fecundity, increased risk of miscarriage and lower success with ART. The review considers traditional and novel biomarkers like anti-Mullerian hormone, antral follicle count, metabolites in follicular fluid, transcriptomic profiles and predictive models using artificial intelligence. Interventions like lifestyle adjustment, antioxidant therapy, mitochondrial therapeutics and fertility preservation through vitrification of oocytes are reviewed in terms of benefit versus limitation. Ethical and social issues, such as disparities in access, ART-associated risks according to age and the control of new technologies are discussed as well. Directions for the future highlight the importance of individualized reproductive strategies and translational research, bridging laboratory observations with clinical results. Awareness of the complex phenomenon of oocyte aging can enhance fertility counselling and reproductive planning during the age of delayed childbearing.