An age-related decline in fertility is a well-known physiologic effect related to decreases in oocyte quantity and quality (ACOG and ASRM, 2014). Older women who conceive naturally have an increased risk of fetal chromosomal abnormalities and pregnancy loss (Spandorfer and Chung, 2004). Despite this association, a global shift towards delayed childbearing has occurred (OECD Family Database, OECD, 2019). Age at first birth and the proportion of pregnancies in women over the age of 35 years have been increasing in the USA since 1980 (Martin et al., 2019).
