Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Many women now choose to develop their careers before having children. Thus, it is becoming increasingly important to assess a woman's potential for extended fertility and to understand the health consequences of having children at a late age. In particular, there is a striking positive correlation between extended fertility and longevity in women, which poses important implications for medicine, biology, and evolution. In this article we review the diverse epidemiologic evidence for the link between fertility potential, age of menopause, and women's lifespan. Then we discuss the recent advances using genomic technology to better understand biological mechanisms driving this association. At the genetic level, there are polymorphisms that may be driving both extended fertility and longevity. At the cellular and molecular levels, changes in the genome (both nuclear and mitochondrial), epigenome, and transcriptome during oocyte aging have important implications for fertility. By synthesizing results from diverse domains, we hope to provide a genomic-era conceptual framework in which this important connection can be investigated and understood.