By Alan B. Copperman, MD, Clinical Professor, Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Director, Division of Reproductive Endocrinology and Infertility, the Mount Sinai Hospital.

Many of us are surprised to hear how difficult it is for humans to conceive. In fact, the chance of getting pregnant during any given cycle is only one in five. As women age, however, the likelihood of conceiving a healthy pregnancy decreases. This is largely due to the age-related decline in ovarian function. When a woman is in her twenties nearly 90% of her eggs are normal, while by the time she is in her forties, nearly 90% of her eggs are chromosomally abnormal. Increased awareness of these data and new emerging treatment modalities are combining to combat the basic biological realities.

Fortunately, we have entered an exciting era in reproductive medicine. Personalized and genomic medicine are providing early awareness for those at risk for infertility. Advances in the field of reproductive medicine allow a woman desiring to delay childbearing the viable pathway of preserving her fertility by freezing her eggs or embryos. Cryopreservation is a fairly new tool in our reproductive arsenal, yet more than 10,000 babies have now been born from this technology and these babies appear normal and healthy.

This is an era in which with treatment, nearly every woman, man, and couple can indeed have a child. Single mothers by choice, same sex female parents and same sex male parents are all now presented with pathways by which they can create the family of their dreams.

Through the use of new technologies, we are now able to analyze embryos to determine if they are chromosomally normal which therefore enables us to transfer only the healthiest of embryos. By electing to transfer a single, chromosomally normal embryo we can dramatically increase the chance of a healthy, viable pregnancy, while nearly eliminating miscarriages. In addition, with a single healthy embryo transfer, we have seen a dramatic decrease in twin pregnancies and no longer see triplet and quadruplet pregnancies. If a woman or a couple has extra normal embryos, they are often able to delay childbearing until they are ready to grow their family.

All of these technologies combine to increase reproductive options to provide the best possible chance of building a family.