Across the Western world, the age at which women become mothers has steadily increased over the past several decades, reflecting profound social, economic, and cultural shifts. In the mid-20th century, first births commonly occurred in a woman’s early to mid-20s, closely tied to earlier marriage and more traditional life trajectories. Today, however, the average age at first birth in most Western countries has moved into the late 20s or early 30s, with a growing proportion of women having their first child at 35 years or older.
Preterm birth, defined as delivery before 37 completed weeks of pregnancy, affects roughly one in ten pregnancies worldwide and remains the leading cause of neonatal mortality. Beyond the immediate risks to newborn survival, babies born too early face higher rates of long-term health challenges, including respiratory disease, neurodevelopmental delays, and chronic conditions that can persist into adulthood.
Advances in reproductive medicine are opening doors that were unimaginable just a generation ago, particularly for women concerned about inherited disease and fertility loss. Emerging technologies such as mitochondrial replacement therapy, gene editing, and the development of artificial gametes promise new ways to prevent severe genetic disorders and expand reproductive options. For women who carry known genetic mutations or who have lost fertility due to age, cancer treatment, or medical conditions, these innovations offer the possibility of having healthy, genetically related children; an outcome that until recently was often out of reach.
Mitochondria are inherited almost exclusively from the mother through the egg cell. During fertilization, the sperm contributes mainly its nuclear DNA, while its mitochondria, located in the sperm’s tail, either fail to enter the egg or are actively destroyed after entry. As a result, all the mitochondria in an embryo come from the mother’s egg, making mitochondrial DNA (mtDNA) maternally inherited.
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder characterized by an interplay between genetic, metabolic, and hormonal abnormalities that lead to ovarian dysfunction, hyperandrogenism, and metabolic disturbances. The pathophysiology begins with insulin resistance, which occurs in many but not all women with PCOS and contributes significantly to its endocrine and metabolic features.
The treatment of polycystic ovary syndrome (PCOS) is multifaceted because the condition involves hormonal imbalance, metabolic dysfunction, and reproductive irregularities. Management typically begins with lifestyle modification, as even a modest 5–10% weight reduction can significantly improve ovulation, insulin sensitivity, and androgen levels.
Epigenetic mechanisms appear to play a significant role in the pathophysiology of polycystic ovary syndrome (PCOS), helping explain how genetic susceptibility interacts with environmental and developmental factors to produce the syndrome’s diverse reproductive and metabolic manifestations.
Multiple sclerosis and Alzheimer’s disease each affect women more often than men, about two to three times as often. Also, two-thirds of healthy women have ‘brain fog’ during menopause. Hormones such as estrogen clearly play a role, but their decline does not fully account for why female brains appear more vulnerable to neuroinflammatory and neurodegenerative processes.
Oral GnRH antagonists have become an important advancement in the medical management of endometriosis and are increasingly being explored for adenomyosis. These agents work by directly blocking GnRH receptors in the pituitary gland, producing an immediate decrease in LH and FSH and therefore suppressing ovarian estrogen production without causing the “flare effect” seen with older GnRH agonists.
CRISPR editing of an embryo’s genes involves using targeted molecular tools to modify DNA at the earliest stages of development, where a single change can propagate to every cell of the developing child. In this context, CRISPR-Cas9 is programmed with a guide RNA that recognizes a specific gene sequence associated with a disease or trait; once it binds, the Cas9 enzyme makes a precise cut in the DNA.
Administering the hepatitis B vaccine at birth is a cornerstone of global public-health strategy because it prevents a lifelong, incurable viral infection at the moment infants are most vulnerable and least likely to be diagnosed. The rationale is grounded in virology, epidemiology, and the unique biology of newborn immunity. Hepatitis B virus (HBV) is transmitted through blood and bodily fluids, and one of the most efficient routes of transmission is perinatal exposure from an infected mother during delivery.
