Chapter by Dr. Silber in Medical Textbook: Biology of the Oocyte

Introduction
It is now possible to preserve and restore fertility, using ovary and egg freezing and ovary transplantation, in young women with cancer who are undergoing otherwise sterilizing chemotherapy and radiation. This approach can also be used for any woman who wishes to prolong her reproductive lifespan. This chapter is limited to the clinically proven therapeutic applications of this technology. Our clinical results with these new therapeutic approaches are adding to our understanding of the basic science of reproduction, and may eventually obviate the growing worldwide epidemic of female age-related decline in fertility.

The developed world is in the midst of a widespread in fertility epidemic. Economies in Japan, the United States, southern Europe, and even China are threatened by a decreasing population of young people having to support an increasing population of elderly and retirees [1]. The most common reason to see a doctor in countries such as India and China, seemingly plagued with overpopulation, is for infertility. Infertility clinics are popping up throughout the world in huge numbers [2]. It is clear to all that the major reason for the world’s growing infertility epidemic is that as women put off childbearing, their oocytes die off and those that survive are of poor quality [3–6]. In her teen years a woman has a 0.2% chance of being infertile, and by her early twenties it is up to2%. By her early thirties, it is up to 20% [2, 7]. Many modern women today do not think of having a baby until their mid thirties, and by then over 25% are infertile, simply because of the aging and the decline in number of their oocytes. This is clearly demonstrated by the high pregnancy rate using donor oocytes from young women placed into the uterus of older women [2, 3, 7]. Yet fertility physicians struggle to make a pathological entity diagnosis to explain the infertility, which in truth in most cases is just a normal physiological response to oocyte aging [2, 3, 7].