Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Obstetrics and Gynecology, University of Colorado Denver, Aurora, Colorado, USA.
Sex Dev. 2023;17(2-3):156-168. doi: 10.1159/000532072. Epub 2023 Aug 18.
While the term "aging" implies a process typically associated with later life, the consequences of ovarian aging are evident by the time a woman reaches her forties, and sometimes earlier. This is due to a gradual decline in the quantity and quality of oocytes which occurs over a woman's reproductive lifespan. Indeed, the reproductive potential of the ovary is established even before birth, as the proper formation and assembly of the ovarian germ cell population during fetal life determines the lifetime endowment of oocytes and follicles. In the ovary, sophisticated molecular processes have been identified that regulate the timing of ovarian aging and these are critical to ensuring follicular maintenance.
The mechanisms thought to contribute to overall aging have been summarized under the term the "hallmarks of aging" and include such processes as DNA damage, mitochondrial dysfunction, telomere attrition, genomic instability, and stem cell exhaustion, among others. Similarly, in the ovary, molecular processes have been identified that regulate the timing of ovarian aging and these are critical to ensuring follicular maintenance. In this review, we outline critical processes involved in ovarian aging, highlight major achievements for treatment of ovarian aging, and discuss ongoing questions and areas of debate.
Ovarian aging is recognized as what may be a complex process in which age, genetics, environment, and many other factors contribute to the size and depletion of the follicle pool. The putative hallmarks of reproductive aging outlined herein include a diversity of plausible processes contributing to the depletion of the ovarian reserve. More research is needed to clarify if and to what extent these putative regulators do in fact govern follicle and oocyte behavior, and how these signals might be integrated in order to control the overall pattern of ovarian aging.
虽然“衰老”一词暗示了一个与晚年相关的过程，但女性到四十多岁时，甚至更早，就已经能明显感受到卵巢衰老的后果。这是由于卵母细胞的数量和质量随着女性的生殖寿命逐渐下降所致。事实上，即使在出生前，卵巢的生殖潜能就已经确定了，因为胎儿期卵巢生殖细胞群体的正确形成和组装决定了卵母细胞和卵泡的终生储备。在卵巢中，已经确定了调节卵巢衰老时间的复杂分子过程，这些过程对于确保卵泡的维持至关重要。
被称为“衰老标志”的术语概括了被认为导致整体衰老的机制，包括 DNA 损伤、线粒体功能障碍、端粒磨损、基因组不稳定性和干细胞耗竭等过程。同样，在卵巢中，已经确定了调节卵巢衰老时间的分子过程，这些过程对于确保卵泡的维持至关重要。在这篇综述中，我们概述了卵巢衰老过程中涉及的关键过程，强调了治疗卵巢衰老的主要成就，并讨论了正在进行的问题和争议领域。
卵巢衰老被认为是一个复杂的过程，其中年龄、遗传、环境和许多其他因素都会影响卵泡池的大小和耗竭。本文概述的生殖衰老的假定标志包括许多可能导致卵巢储备耗竭的过程。需要进一步的研究来澄清这些假定的调节因子是否以及在何种程度上确实控制了卵泡和卵母细胞的行为，以及这些信号如何整合以控制卵巢衰老的整体模式。
