Competence Centre on Health Technologies, Tiigi 61b, Tartu, Estonia.
Institute of Clinical Medicine, Department of Obstetrics and Gynaecology, University of Tartu, L. Puusepa 8, Tartu, Estonia.
Hum Reprod Update. 2019 Jan 1;25(1):34-50. doi: 10.1093/humupd/dmy031.
The human female reproductive lifespan is regulated by the dynamics of ovarian function, which in turn is influenced by several factors: from the basic molecular biological mechanisms governing folliculogenesis, to environmental and lifestyle factors affecting the ovarian reserve between conception and menopause. From a broader point of view, global and regional demographic trends play an additional important role in shaping the female reproductive lifespan, and finally, influences on an evolutionary scale have led to the reproductive senescence that precedes somatic senescence in humans.
The narrative review covers reproductive medicine, by integrating the molecular mechanisms of ovarian function and aging with short-term demographic and long-term evolutionary trends.
PubMed and Google Scholar searches were performed with relevant keywords (menopause, folliculogenesis, reproductive aging, reproductive lifespan and life history theory). The reviewed articles and their references were restricted to those written in English.
We discuss and summarize the rapidly accumulating information from large-scale population-based and single-reproductive-cell genomic studies, their constraints and advantages in the context of female reproductive aging as well as their possible evolutionary significance on the life history trajectory from foetal-stage folliculogenesis until cessation of ovarian function in menopause. The relevant environmental and lifestyle factors and demographic trends are also discussed in the framework of predominant evolutionary hypotheses explaining the origin and maintenance of menopause.
The high speed at which new data are generated has so far raised more questions than it has provided solid answers and has been paralleled by a lack of satisfactory interpretations of the findings in the context of human life history theory. Therefore, the recent flood of data could offer an unprecedented tool for future research to possibly confirm or rewrite human evolutionary reproductive history, at the same time providing novel grounds for patient counselling and family planning strategies.
人类女性生殖寿命受卵巢功能动态调节，而卵巢功能又受多种因素影响：从控制卵泡发生的基本分子生物学机制，到影响受孕至绝经期间卵巢储备的环境和生活方式因素。从更广泛的角度来看，全球和区域人口趋势在塑造女性生殖寿命方面发挥着额外的重要作用，最终，在进化规模上的影响导致了人类生殖衰老先于躯体衰老。
本综述涵盖生殖医学，将卵巢功能和衰老的分子机制与短期人口趋势和长期进化趋势相结合。
使用相关关键字（绝经、卵泡发生、生殖衰老、生殖寿命和生命史理论）在 PubMed 和 Google Scholar 上进行搜索。综述文章及其参考文献仅限于用英文撰写的文章。
我们讨论并总结了来自大规模基于人群的和单个生殖细胞基因组研究的快速积累信息，以及它们在女性生殖衰老背景下的局限性和优势，以及它们在从胎儿期卵泡发生到绝经时卵巢功能停止的生命史轨迹上的可能进化意义。还讨论了相关的环境和生活方式因素以及人口趋势，并在解释绝经起源和维持的主要进化假说框架内进行了讨论。
新数据的生成速度如此之快，迄今为止提出的问题多于提供的明确答案，并且与人类生命史理论背景下对研究结果的不满意解释相平行。因此，最近的数据洪流可能为未来的研究提供一个前所未有的工具，以可能证实或重写人类进化生殖史，同时为患者咨询和计划生育策略提供新的依据。
