Department of Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey.
Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, USA.
Curr Opin Obstet Gynecol. 2019 Jun;31(3):139-147. doi: 10.1097/GCO.0000000000000536.
Diminished ovarian reserve, in general, implies a quantitative decline in the oocyte pool. However, whether this quantitative decline is necessarily accompanied by a qualitative decline, remains to be determined.
Studies of natural conception suggest that fecundity of women with a quantitative decline in ovarian reserve is similar to age-matched women with normal ovarian reserve. Data on rates of pregnancy loss and fetal chromosomal abnormality do not consistently suggest a decline in oocyte quality in women who has a lower ovarian reserve. In assisted reproductive technology (ART) cycles, oocytes from women with diminished ovarian reserve have similar potential for euploid blastocyst development. Likewise, available evidence does not strongly suggest an increased risk of pregnancy loss in women with diminished reserve undergoing ART treatment as compared with similarly aged woman with normal ovarian reserve.
Quantitative decline in ovarian reserve may not be necessarily accompanied by a qualitative decline. Although a decreased number of follicles and poor response to ovarian stimulation are hallmarks of ovarian aging, younger women with diminished ovarian reserve may not be experiencing the distinct effects of aging on oocyte quality.
卵巢储备功能减退通常意味着卵母细胞池的数量减少。然而，这种数量的减少是否必然伴随着质量的下降，仍有待确定。
对自然受孕的研究表明，卵巢储备功能减退的女性的生育能力与正常卵巢储备功能的同龄女性相似。关于流产率和胎儿染色体异常的数据并不一致表明卵巢储备功能降低的女性的卵母细胞质量下降。在辅助生殖技术（ART）周期中，卵巢储备功能减退的女性的卵母细胞具有相似的发育为整倍体囊胚的潜力。同样，现有的证据也没有强烈表明与具有正常卵巢储备功能的同龄女性相比，接受 ART 治疗的储备功能减退的女性的流产风险增加。
卵巢储备功能的减退可能不一定伴随着质量的下降。虽然卵泡数量减少和对卵巢刺激反应不良是卵巢衰老的特征，但卵巢储备功能减退的年轻女性可能没有经历卵母细胞质量因衰老而产生的明显变化。
