Impact of Maternal Age on Embryo Quality and Implantation Success.pdf

Maternal age is a critical determinant of reproductive capacity, with rising age bringing important challenges to natural and assisted conception. The present review aims to bring together the latest evidence for the impact of increasing maternal age on oocyte quality, embryo morphology, chromosomal integrity, and implantation rates, specifically within assisted reproductive technologies (ART) such as IVF and ICSI. Elderly maternal age (≥35 years) is linked with progressive ovarian reserve decline, compromised oocyte competence, and disproportionately increased embryonic aneuploidy. Maternal aging has severe impacts on blastocyst viability and implantation potential but causes little effect on fertilization and early embryonic development. Other contributory factors are mitochondrial dysfunction, epigenetic changes, and reduced endometrial receptivity. Although advancements such as preimplantation genetic testing (PGT-A) and oocyte vitrification provide improvements, the cumulative live birth rate (CLBR) markedly declines with increasing age. The clinical importance of reproductive aging is acknowledged by this review while underlining the need for early fertility evaluation, fertility preservation options, and ongoing research into enhancing ART outcomes among elderly women.