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Questions for Dr. Kennedy
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Hormone Replacement Therapy and Fertility
Posted by: Susan
Date: March 27, 2002 11:48 PM

Question about Hormone Replacement Therapy and of particular interest was the conversation about aging as it relates to living long enough to reproduce and raise the offspring. The question I have is this: many women are now having children in their late thirties and early forties. However, some are unable because the number of eggs that can be fertilized decreases with age. Would Hormone Replacement Therapy have any effects on maintaining, if not lengthening, her reproductive biological life? I am looking at the possibility of having kids in my early forties and want to look into HRT as a means of staying young, healthy, and fertile so that I may have children and have the energy for them as well!

RE: Hormone Replacement Therapy and Fertility
Posted by: Ron Kennedy, M.D.
Date: March 28, 2002 4:52 AM

There are a finite number of eggs in each ovary. A small percentage of those are not up to the task of ovulation. When the eggs which will ovulate are used up, menopause has its onset. That time varies with each woman depending on the number of robust eggs present. If you look at the incidence of menopause in a population of women, it presents as a Bell shaped curve between the ages of about 32 and 57 with the top of the curve occurring in the mid to late 40s. Ovulation ignites the menstrual cycle through creation of a temporary gland called the corpus luteum. The corpus luteum produces progesterone which has the effect on the uterus of preparing it for the possible implantation of a fertilized egg. This is a very delicately balanced system and I am not aware that it can be manipulated by the addition of hormones from outside the system. It is certainly reasonable to expect to maintain youth of the rest of the body through HRT, but I doubt one could induce cells which are not already able to ovulate to change their minds on the issue. I have no idea how one could calculate when the last egg will come down the pike. It is a dice roll where you will fall in that Bell shaped curve. So, if having children is of transcendent importance to you, perhaps you should have your children earlier rather than later just to be on the safer side. Also, as you know, the incidence of birth defects increases with the age of the mother at the time of birth.



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