Division of Reproductive Endocrinology and Infertility, College of Physicians and Surgeons, Columbia University, New York, New York.
Fertil Steril. 2015 May;103(5):1136-43. doi: 10.1016/j.fertnstert.2015.03.004.
Advanced age is a risk factor for female infertility, pregnancy loss, fetal anomalies, stillbirth, and obstetric complications. These concerns are based on centuries-old observations, yet women are delaying childbearing to pursue educational and career goals in greater numbers than ever before. As a result, reproductive medicine specialists are treating more patients with age-related infertility and recurrent pregnancy loss, while obstetricians are faced with managing pregnancies often complicated by both age and comorbidities. The media portrayal of a youthful but older woman, able to schedule her reproductive needs and balance family and job, has fueled the myth that "you can have it all," rarely characterizing the perils inherent to advanced-age reproduction. Reproductive medicine specialists and obstetrician/gynecologists should promote more realistic views of the evidence-based realities of advanced maternal age pregnancy, including its high-risk nature and often compromised outcomes. Doctors should also actively educate both patients and the public that there is a real danger of childlessness if individuals choose to delay reproduction.
高龄是女性不孕、妊娠丢失、胎儿畸形、死产和产科并发症的一个危险因素。这些担忧基于几个世纪以来的观察，但现在越来越多的女性为了追求教育和职业目标而推迟生育。因此，生殖医学专家正在治疗更多与年龄相关的不孕和复发性妊娠丢失的患者，而产科医生则面临着管理因年龄和合并症而变得复杂的妊娠。媒体对一个年轻但年龄较大的女性的描绘，能够安排她的生育需求并平衡家庭和工作，这加剧了“你可以拥有一切”的神话，很少描述高龄生育所固有的危险。生殖医学专家和妇产科医生应该更现实地看待高龄产妇妊娠的循证现实，包括其高风险性质和经常不理想的结局。医生还应该积极教育患者和公众，如果个人选择推迟生育，确实存在无法生育的危险。
