The making of 'old eggs': the science of reproductive ageing between fertility and anti-ageing technologies

Social egg freezing as ambivalent materialities of aging

This commentary explores how the material-nonmaterial transactions around reproduction among women raise paradoxical questions of reproductive autonomy and commercialization of reproduction. Drawing from medical anthropological studies on human reproduction, the technology around social egg freezing has been conceived to proffer ambivalent possibilities of hope, despair, and repair as mature women recalibrate their reproductive identities, especially in pronatalist contexts. Building on the material-discursive critique of the 'material turn', I ask if social egg freezing offers an empowering biological reprieve for women who have 'chosen' a non-normative (i.e., a departure from heterosexual conjugality) life-course. Subsequently, how does one "do age" when material entanglements (here, reproductive technologies) disrupt the symbolic performance of the life-course? Or, does this reproductive autonomy actualized through social egg freezing align well with the neoliberal prerogatives of "successful aging," thereby intensifying the specter of the "Third Age"? Overall, through an analysis of (reproductive) technologies, as well as the question of choice and social bodies, I argue how new materialities and anxieties of growing old can undergird the material-cultural link in gerontology.

Efficacy of Qizi Yusi Pill on Pregnancy Outcomes in Women of Advanced Reproductive Age: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

OBJECTIVE

To evalvate efficacy of Qizi Yusi Pills (QYP), a Chinese medicine compound preparation, on in vitro fertilization-embryo transfer (IVF-ET) in women of advanced reproductive age.

METHODS

This multicenter, randomized, double-blind, placebo-controlled trial was conducted from June 2018 to October 2019. A total of 124 patients were randomly allocated to either the QYP group or the placebo group using a stratified block randomization design, with 62 patients in each group. All patients completed controlled ovarian stimulation using a standard gonadotropin-releasing hormone agonist (GnRH-a) long protocol. As the QYP group, QYP was administered while the control group received placebo. QYP and placebo were administered for a total of 24 to 30 days from the day of GnRH-a pituitary downregulation to transvaginal oocyte retrieval. Both medications were taken orally at doses of 10 g three times each day. The primary outcome was cumulative pregnancy rate, and the secondary outcomes were periodic medication, follicular status, serum hormone and endometrial receptivity. Follow-up continued until 4 weeks after delivery. Maternal and neonatal complications, such as gestational diabetes, were also observed.

RESULTS

Overall, 119 patients completed the study, 60 in the QYP group and 59 in the placebo group. Per protocol (PP) analysis revealed that 6-month cumulative pregnancy rate in the QYP group was significantly higher than that in the placebo group [43.33% (26/60) vs. 25.42% (15/59), P=0.040). Additionally, more oocytes were retrieved from the QYP group than those from the placebo group (8.95 ± 3.12 vs. 7.85 ± 1.91, P=0.022). Moreover, the endometrial thickness of HCG day in the QYP group was significantly higher than that in the placebo group (11.78 ± 2.27 mm vs. 10.68 ± 2.07 mm, P=0.012). Maternal and neonatal complications between the two groups were not significantly different (P>0.05). Intention-to-treat analysis was in line with PP results.

CONCLUSIONS

QYP can enhance ovarian reserve capacity and ovarian response, and possibly promote endometrial receptivity. QYP effectively improves cumulative pregnancy rates in older patients (⩾35 years) undergoing IVF-ET. (Registration No. ChiCTR1800014427).

The 'good' of extending fertility: ontology and moral reasoning in a biotemporal regime of reproduction

Since the emergence of in-vitro fertilization (IVF), a specific set of technologies has been developed to address the problem of the 'biological clock'. The medical extension of fertility time is accompanied by promissory narratives to help women synchronize conflicting biological and social temporalities. This possibility also has a transgressive potential by blurring one of the biological landmarks - the menopause - by which reproductive lives are organized and governed. These new ways of managing, measuring and controlling reproductive time have renewed debates on the age limits of motherhood and the moral legitimacy of medical intervention into age-related fertility decline. Building on Amir's feminist concept of biotemporality, this paper questions what happens when the ontological foundations of age-limited motherhood are disrupted by technologies which allow fertility to be extended. It discusses the reconfigurations of the ontological boundaries of the facts of life in the light of literature on reproductive technologies and temporality. Through the Swiss experience, the paper shows how medical experts are drawn into negotiating the ontological boundaries of age-limited motherhood along the binaries of the normal/pathological and the biological/social. Questioning the purpose of medical interventions in what are seen as facts of life, they produce different configurations of moral reasoning where what is natural undergoes shifts which both reinforce the normative order and subvert it.