Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Melbourne, Level 7 Royal Women's Hospital, 50 Flemmington Parade, Parkville, 3052, Australia; Melbourne IVF, 340 Victoria Parade, East Melbourne, 3002, Australia.
Best Pract Res Clin Obstet Gynaecol. 2019 Feb;55:2-13. doi: 10.1016/j.bpobgyn.2018.05.005. Epub 2018 Jun 28.
This chapter describes ovarian anatomy and embryology in humans. The formation of the ovarian reserve is discussed, and events of folliculogenesis are described, including description of developmental events in primordial, primary, secondary, antral and periovulatory follicles. Paracrine and autocrine factors play critical roles in oocyte maturation and follicular development, and research related to the hypothesised roles of individual factors is discussed. Gonadotrophin-dependent events relating to dominant follicle selection are discussed. The two-cell, two-gonadotrophin hypothesis of ovarian steroidogenesis is explained. The clinical role of AMH is outlined. Premature ovarian failure and known associated aetiological factors are described. In the conclusion, with an understanding of the principle events of ovarian folliculogenesis, the follicular wave theory is described, and it is explained how adaptation of ovarian stimulation regimens may achieve time-efficient fertility preservation treatment options for patients with cancer.
本章描述了人类的卵巢解剖结构和胚胎学。讨论了卵巢储备的形成，并描述了卵泡发生的事件，包括原始卵泡、初级卵泡、次级卵泡、窦前卵泡和排卵前卵泡的发育事件。旁分泌和自分泌因子在卵母细胞成熟和卵泡发育中起着关键作用，讨论了与个别因子假设作用相关的研究。讨论了与优势卵泡选择相关的促性腺激素依赖性事件。解释了卵巢甾体生成的“双细胞、双促性腺激素”假说。概述了 AMH 的临床作用。描述了卵巢早衰和已知的相关病因因素。在结论中，通过了解卵巢卵泡发生的主要事件，描述了卵泡波理论，并解释了如何调整卵巢刺激方案以实现针对癌症患者的高效时间的生育力保存治疗选择。
