The number of women seeking treatment for infertility continues to grow. It is estimated that approximately 1 in 136 or two million people in United States are infertile (1). These numbers are explained, in part, by an age-related decline in fertility that is well documented in the medical literature. Despite the availability of new technologies such as in vitro fertilization (IVF), this age-related loss of fertility cannot be overcome by the use of assisted reproductive technologies (ART), if donor oocytes are not used (2–10).

ART has been viewed as a panacea for perimenopausal women seeking motherhood late in their reproductive lives. According to the 2003 CDC Assisted Reproductive Technology Report (11), 20 percent of women seeking ART were of the age of forty and older. Most women in this age-group either delayed childbearing to pursue higher education and careers, or are part of the large cohort of women born during the “baby boom” (1946–1964) period. Although these women can have spontaneous pregnancies, the likelihood of pregnancy and live birth is less than 1–2 percent in those older than forty-three (11), and the time to conception can be prolonged.

Age is the most important factor affecting the chance of a live birth when a woman uses her own eggs. Among women in their twenties, pregnancy and live birth rates are relatively stable; and decline steadily from the mid-thirties onward (11).