{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:10:42Z","timestamp":1781712642494,"version":"3.54.5"},"reference-count":119,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Changes in societal norms over the last few decades have resulted in novel family planning trends, notably delayed childbearing and increased maternal age at the birth of the first child. Despite advances in reproductive medicine, ageing poses significant challenges. Natural conception in women \u2265\u200945\u2009years of age is rare, with high rates of pregnancy loss, and assisted reproduction using autologous oocytes yields limited success. Oocyte donation offers higher live birth rates, exceeding 50%. Elective oocyte cryopreservation could aid in family planning; nevertheless, its success depends on the age at which cryopreservation is performed. These facts highlight the correlation between advancing age and a decline in oocyte quality and quantity. An age\u2010related decline in endometrial receptivity could pose an additional barrier, although the evidence remains controversial. Furthermore, pregnancies in older women carry high risks for both the mother and child, which should be considered before assisted conception attempts. This comprehensive narrative review examines the advancements in assisted reproductive technology that have expanded the possibilities for delayed childbearing, while underlining at the same time the major challenges in the field. Innovations such as ovarian tissue cryopreservation and stem cell\u2010based therapies have the potential to reshape reproductive options for these women. However, thorough counselling and tailored management remain of paramount importance.<\/jats:p>","DOI":"10.1111\/1471-0528.70197","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:57:11Z","timestamp":1773125831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Reproductive Challenges of the Ageing Female: A Comprehensive Narrative Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5746-9517","authenticated-orcid":false,"given":"Sofia","family":"Bitzika","sequence":"first","affiliation":[{"name":"Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, School of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meletios P.","family":"Nigdelis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, School of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"},{"name":"Clinic for Gynaecology, Obstetrics and Reproductive Medicine, Faculty of Medicine Saarland University  Homburg\/Saar Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelos","family":"Daniilidis","sequence":"additional","affiliation":[{"name":"First Department of Obstetrics and Gynaecology, School of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erich\u2010Franz","family":"Solomayer","sequence":"additional","affiliation":[{"name":"Clinic for Gynaecology, Obstetrics and Reproductive Medicine, Faculty of Medicine Saarland University  Homburg\/Saar Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Lambrinoudaki","sequence":"additional","affiliation":[{"name":"Second Department of Obstetrics and Gynaecology, School of Medicine National and Kapodistrian University of Athens  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstratios M.","family":"Kolibianakis","sequence":"additional","affiliation":[{"name":"Unit of Human Reproduction, First Department of Obstetrics and Gynaecology, School of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios G.","family":"Goulis","sequence":"additional","affiliation":[{"name":"Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynaecology, School of Medicine Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"3","key":"e_1_2_16_2_1","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.maturitas.2011.07.003","article-title":"Fertility After Age 45: From Natural Conception to Assisted Reproductive Technology and Beyond","volume":"70","author":"Forman E. 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