419662

The Fertility Crossroad: Navigating the Divide between Unexplained and Age-Related Infertility; Where is the Cliff?

Article

Last updated: 09 Apr 2025

Subjects

-

Tags

Assisted reproduction

Abstract

Unexplained infertility (UEI) and advanced maternal age (AMA) provide considerable obstacles to reproductive treatment. Unexplained infertility is a diagnosis of exclusion; nonetheless, therapies like intrauterine insemination (IUI) and in vitro fertilization (IVF) can enhance outcomes. Age-related infertility is mainly caused by decreased oocyte number and quality and increased aneuploidy rate. The decline in fertility associated with ageing is predominantly permanent, highlighting the necessity of early intervention and fertility preservation. There are crossroads between these two entities. We should know where the cliff is so we can intervene early before the prognosis becomes poor. Expectant management and intrauterine insemination are viable initial approaches for younger women; maternal age necessitates a shift toward ovarian reserve assessment and prognosis-based interventions. Preimplantation genetic testing for aneuploidy (PGT-A) may enhance reproductive success, though it remains debated due to cost and variable efficacy. The outcomes of assisted reproductive techniques (ART) decline significantly beyond the age of 40, with live birth rates becoming negligible after 44. A strategic, individualized approach balancing natural conception, fertility preservation, and assisted reproduction is essential for optimizing reproductive success in UEI and ARI cases.

DOI

10.21608/jrme.2025.362573.1030

Keywords

Age-related infertility, advanced maternal age, unexplained infertility and PGT-A

Authors

First Name

Ola

Last Name

Youssef

MiddleName

-

Affiliation

Obstetrics and Gynecology Department, Alexandria University, Egypt., Egyptian Foundation of Reproductive Medicine and Embryology (EFRE), Egypt.

Email

olayoussef_n@hotmail.com

City

Alexandria

Orcid

0000-0001-7690-2594

First Name

Hassan

Last Name

Maghraby

MiddleName

-

Affiliation

Obstetrics and Gynecology Department, Alexandria University, Egypt., Egyptian Foundation of Reproductive Medicine and Embryology (EFRE), Egypt.

Email

hassanmaghraby@gmail.com

City

-

Orcid

0000-0003-3661-1594

Volume

1

Article Issue

4

Related Issue

54794

Issue Date

2025-02-01

Receive Date

2025-02-21

Publish Date

2025-02-01

Page Start

230

Page End

234

Online ISSN

3009-7282

Link

https://jrme.journals.ekb.eg/article_419662.html

Detail API

http://journals.ekb.eg?_action=service&article_code=419662

Order

4

Type

Narrative (literature review)

Type Code

3,009

Publication Type

Journal

Publication Title

Journal of Reproductive Medicine and Embryology

Publication Link

https://jrme.journals.ekb.eg/

MainTitle

The Fertility Crossroad: Navigating the Divide between Unexplained and Age-Related Infertility; Where is the Cliff?

Details

Type

Article

Created At

09 Apr 2025