The spectrum of poor reproductive performance with aging extends beyond the declining chances of conception. The association of reproductive aging and escalating pregnancy loss is well known. Miscarriage rates of 34% and 53% have been demonstrated in women aged 40 and 45 years, respectively, against a background rate of 15% for women aged younger than 35 years. Chromosomal abnormalities have been shown in as many as 60% to 70% of embryos resulting from in vitro fertilization ( IVF ) in women of advanced reproductive age. Common karyotypic abnormalities associated with advancing maternal age, which may result in ongoing pregnancies, include trisomy 21, 18, and 13. Improved pregnancy rates following IVF have been demonstrated in women of advanced reproductive age, using selection of chromosomally normal embryos by preimplantation genetic diagnosis (PGD) testing.