Advanced maternal age and Miscarriage

Miscarriage is spontaneous pregnancy loss before 20th weeks of gestation and Aneuploidy is aprincipal factor in miscarriage.There is a relationship between maternal age and miscarriage rate, from 10 percent in age 20 to 90percent in age above 45 years .advance paternal age, which is frequently associated with advancematernal age increases the risk of autosomal dominant diseases (new genetic mutations).Epigenetic factors (modification of gene expression rather than alteration of genetic code) also havebeen associated with spontaneous abortion that occurs in ART cycles. ART may exacerbate defectsin methylation and epigenosis.With aging there is a decrease in number of follicles and AMH level.AMH can be measured on any day menstrual cycle but recent evidenced demonstrates thatcirculating AMH level may be suppressed in long term users of hormonal contraceptives.The patient with low AMH have poorer quality oocytes (sub fertile). Some studies indicate that it isnot associated with a longer time to conception but may be increases the risk of miscarriage.Further research is needed to assess the potential relationship of AMH and pregnancy outcomes, inparticular miscarriage rates.