Reproductive ageing affects both individuals and wider society, and obstetricians and gynaecologists are witness to the impact of reproductive ageing and to some of the fears and misapprehensions of the general public. This book raises awareness of societal trends and their implications. The wider importance of the subject to the whole of society is emphasized by contributions from outside the world of obstetrics and gynaecology, both within and outside medicine. The 56th RCOG Study Group brought together a range of experts to examine reproductive ageing. This book presents the findings of the Study Group, with sections covering:
* background to ageing and demographics
* basic science of reproductive ageing
* pregnancy: the ageing mother and medical needs
* the outcomes: children and mothers
* future fertility insurance: screening, cryopreservation or egg donors?
* sex beyond and after fertility
* fertility treatment: science and reality - the NHS and the market
* the future: dreams and waking up.
Part I. Background to Ageing and Demographics: 1. Ageing: what is it and why does it happen? Finbarr Martin and Jane Preston; 2. Culture and reproductive ageing Maya Unnithan; 3. Ageing; 4. What has happened to reproduction in the 20th century? Beverley Botting; 5. Trends in fertility: what does the 20th century tell us about the 21st? Stijn Hoorens; 6. Demographics; Part II. Basic Science of Reproductive Ageing: 7. Is ovarian ageing inexorable? Roger Gosden and Lucinda Veeck Gosden; 8. The science of ovarian ageing: how might knowledge be translated into practice? Stephen G. Hillier; 9. Basic science: eggs and ovaries; 10. Male reproductive ageing Herman Tournaye; 11. The science of the ageing uterus and placenta Gordon C. S. Smith; 12. Basic science: sperm and placenta; Part III. Pregnancy: The Ageing Mother and Medical Needs: 13. The effect of age on obstetric (maternal and fetal) outcomes Anna Kenyon and Susan Bewley; 14. The older mother and medical disorders of pregnancy Mandish K. Dhanjal; 15. The ageing mother and medical needs; Part IV. The Outcomes: Children and Mothers: 16. What is known about children born to older parents? Alastair Sutcliffe and Yasmin Baki; 17. Consequences of changes in reproductive patterns on later health in women: a life course approach Gita Mishra and Rachel Cooper; 18. The outcomes: children and mothers; Part V. Future Fertility Insurance: Screening, Cryopreservation or Egg Donors?: 19. Screening for early ovarian ageing Abha Maheshwari, Ahmed Gibreel and Siladitya Bhattacharya; 20. Egg freezing: the reality and practicality Helen Picton and Emma Chambers; 21. Assisted conception: uses and abuses Melanie Davies; 22. Future fertility insurance; Part VI. Sex beyond and after Fertility: 23. Contraception for older couples Diana Mansour; 24. Ageing, infertility and gynaecological conditions: how do they affect sexual function? Catherine Coulson; 25. Sex beyond and after fertility; Part VII. Reproductive Ageing and the RCOG: An International College: 26. What should be the RCOG's relationship with older women? Donna Dickenson; 27. Reproductive ageing and the RCOG; Part VIII. Fertility Treatment: Science and Reality - The NHS and the Market: 28. Evidence-based and cost-effective fertility investigation and treatment of older women: moving beyond NICE David Barlow; 29. Bang for the buck: what purchasers and commissioners think and do Berkeley Greenwood; 30. Fertility treatment: science and reality - the NHS and the market; Part IX. The Future: Dreams and Waking Up: 31. In our wildest dreams: making gametes Peter Braude; 32. The future: dreams; 33. Managing expectations and achieving realism: the individual journey from hope to closure Kate Brian; 34. Managing expectations and achieving realism: the 'realpolitik' of reproductive ageing and its consequences Zoe Williams; 35. The future: waking up; Part X. Consensus Views: 36. Consensus views arising from the 56th Study Group: Reproductive Ageing; Index.
Susan Bewley is a Consultant at St Thomas' Hospital, London. William Ledger is a Professor working in the School of Women's and Children's Health at the University of New South Wales, Australia. Dimitrios Nikolaou is a Senior Consultant Gynaecologist and Specialist in Reproductive Medicine and Surgery at Chelsea and Westminster Hospital, London.
