Fig. 4

Potential effects of the assisted reproductive technology (ART) applications and ovarian aging on reproductive features. Ovarian stimulation, in vitro culture conditions, cryopreservation, and ovarian aging enable to change telomere length (TL) and telomerase activity (TA) trough increasing oxidative stress, epigenetic changes, mitochondrial dysfunction, and genomic effects (by the way of regulating Tert gene expression). As a consequence of these effects, while oocyte and embryo quality as well as pregnancy rates decrease, the other features involving recurrent miscarriage, growth restriction, and aneuploidy rates increase. This schematic diagram was created using the BioRender Program (BioRenderCompany; Toronto, Canada)