ACOG Committee Statement No. 22: Anticipatory Counseling Regarding Ovarian-Factor Fertility Decline

Fertility, or the capacity to produce a child, declines with age as the ovaries undergo a natural decrease in follicle count related to oocyte atresia. However, patients significantly overestimate the likelihood of pregnancy at all ages. It is important that health care professionals educate patients regarding the natural decline in ovarian reserve and quality of egg follicles throughout their reproductive lifespans. Patients who are interested in becoming pregnant also should be educated on non-age-related factors that may accelerate ovarian decline to optimize and more completely understand their reproductive health and family-building opportunities. Despite the existence of resources on ovarian decline and non-age-related factors affecting fertility, more evidence-based resources on ovarian decline are needed for both patients and health care professionals.