Global Clinical Development, Merck KGaA, 64293 Darmstadt, Germany.
Department of Histology and Embryology, University of Health Sciences, Saint Camillus International, Via di Sant'Alessandro 8, 00131 Rome, Italy.
Int J Mol Sci. 2024 Jul 9;25(14):7520. doi: 10.3390/ijms25147520.
Female fertility depends on the ovarian reserve of follicles, which is determined at birth. Primordial follicle development and oocyte maturation are regulated by multiple factors and pathways and classified into gonadotropin-independent and gonadotropin-dependent phases, according to the response to gonadotropins. Folliculogenesis has always been considered to be gonadotropin-dependent only from the antral stage, but evidence from the literature highlights the role of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) during early folliculogenesis with a potential role in the progression of the pool of primordial follicles. Hormonal and molecular pathway alterations during the very earliest stages of folliculogenesis may be the root cause of anovulation in polycystic ovary syndrome (PCOS) and in PCOS-like phenotypes related to antiepileptic treatment. Excessive induction of primordial follicle activation can also lead to premature ovarian insufficiency (POI), a condition characterized by menopause in women before 40 years of age. Future treatments aiming to suppress initial recruitment or prevent the growth of resting follicles could help in prolonging female fertility, especially in women with PCOS or POI. This review will briefly introduce the impact of gonadotropins on early folliculogenesis. We will discuss the influence of LH on ovarian reserve and its potential role in PCOS and POI infertility.
女性生育能力取决于卵泡的卵巢储备，而卵泡储备在出生时就已确定。原始卵泡的发育和卵母细胞的成熟受多种因素和途径的调控，并根据对促性腺激素的反应分为促性腺激素依赖和非依赖阶段。根据人们一直以来的认识，卵泡发生仅从窦前阶段起就一直被认为是促性腺激素依赖的，但来自文献的证据强调了卵泡刺激素（FSH）和黄体生成素（LH）在早期卵泡发生过程中的作用，它们可能在原始卵泡库的进展中发挥作用。在卵泡发生的最早阶段，激素和分子途径的改变可能是多囊卵巢综合征（PCOS）和与抗癫痫药物治疗相关的 PCOS 样表型无排卵的根本原因。原始卵泡过度激活也可能导致卵巢早衰（POI），即女性在 40 岁之前绝经。未来旨在抑制初始募集或阻止休眠卵泡生长的治疗方法可能有助于延长女性生育能力，尤其是对患有 PCOS 或 POI 的女性。本文将简要介绍促性腺激素对早期卵泡发生的影响。我们将讨论 LH 对卵巢储备的影响及其在 PCOS 和 POI 不孕中的潜在作用。
