Collaborative Innovation Center for Birth Defect Research and Transformation of Shandong Province, Jining Medical University, Jining, China.
College of Second Clinical Medical, Jining Medical University, Jining, China.
Reprod Sci. 2023 Dec;30(12):3428-3442. doi: 10.1007/s43032-023-01300-1. Epub 2023 Jul 17.
Premature ovarian insufficiency (POI) is a condition in which a woman experiences premature decline in ovarian function before the age of 40 years, manifested by menstrual disorders, decreased fertility, and possibly postmenopausal symptoms such as insomnia, hot flashes, and osteoporosis, and is one of the predominant clinical syndromes leading to female infertility. Genetic, immunologic, iatrogenic and other factors, alone or in combination, have been reported to trigger POI, yet the etiology remains unknown in most cases. The main methods currently used clinically to ameliorate menopausal symptoms due to hypoestrogenemia in POI patients are hormone replacement therapy, while the primary methods available to address infertility in POI patients are oocyte donation and cryopreservation techniques, both of which have limitations to some degree. In recent years, researchers have continued to explore more efficient and safe therapies, and have achieved impressive results in preclinical trials. In this article, we will mainly review the three most popular therapies and their related signaling pathways published in the past ten years, with the aim of providing ideas for clinical applications.
卵巢早衰(POI)是指女性在 40 岁之前出现卵巢功能过早衰退的情况,表现为月经紊乱、生育能力下降,以及可能出现失眠、热潮红和骨质疏松等绝经后症状,是导致女性不孕的主要临床综合征之一。遗传、免疫、医源性等因素单独或联合作用都可能引发 POI,但大多数情况下其病因仍不清楚。目前临床上主要采用激素替代疗法来改善 POI 患者因雌激素水平降低引起的绝经症状,而 POI 患者解决不孕问题的主要方法是卵母细胞捐赠和冷冻保存技术,但这两种方法都在一定程度上存在局限性。近年来,研究人员不断探索更有效和安全的治疗方法,并在临床前试验中取得了令人瞩目的成果。本文主要综述过去十年发表的三种最受欢迎的治疗方法及其相关信号通路,以期为临床应用提供思路。