Kobayashi Hiroshi, Imanaka Shogo
Department of Gynecology and Reproductive Medicine, Ms.Clinic MayOne, Kashihara, Japan.
Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Japan.
J Obstet Gynaecol Res. 2025 Jan;51(1):e16166. doi: 10.1111/jog.16166. Epub 2024 Nov 21.
In developed nations, women have increasingly deferred childbearing, leading to a rise in demand for infertility treatments and the widespread use of assisted reproductive technologies. However, despite advancements in in vitro fertilization (IVF), live birth rates among women over 40 remain suboptimal. Mitochondrial dysfunction is widely recognized as a key factor in the processes driving the age-related deterioration in both the quantity and quality of oocytes. We aim to summarize current insights into ovarian aging, with a particular focus on pathways that impair mitochondrial function, and explore directions for future research.
Electronic databases were searched for articles published up to June 30, 2024.
Ongoing ovulation, luteolysis, and menstruation trigger exogenous reactive oxygen species (ROS)-mediated oxidative stress that damages mitochondrial DNA. This, in turn, reduces nuclear gene expression, compromises mitochondrial oxidative phosphorylation, and diminishes adenosine 5' triphosphate production. Persistent endogenous ROS further exacerbate mitochondrial DNA damage and aneuploidy, ultimately causing irreversible chromosomal abnormalities, leading to oocyte aging.
We have delineated the pathway from oxidative stress to ovarian aging. Early detection and management of ovarian aging present challenges and opportunities to enhance IVF treatment strategies.
在发达国家，女性生育年龄越来越晚，导致不孕治疗需求增加以及辅助生殖技术的广泛应用。然而，尽管体外受精（IVF）技术取得了进展，但40岁以上女性的活产率仍然不尽人意。线粒体功能障碍被广泛认为是导致卵母细胞数量和质量随年龄下降的关键因素。我们旨在总结目前对卵巢衰老的认识，特别关注损害线粒体功能的途径，并探索未来研究方向。
检索电子数据库中截至2024年6月30日发表的文章。
持续的排卵、黄体溶解和月经会引发外源性活性氧（ROS）介导的氧化应激，从而损害线粒体DNA。这进而会降低核基因表达，损害线粒体氧化磷酸化，并减少三磷酸腺苷的产生。持续的内源性ROS会进一步加剧线粒体DNA损伤和非整倍体，最终导致不可逆转的染色体异常，从而导致卵母细胞衰老。
我们已经阐明了从氧化应激到卵巢衰老的途径。卵巢衰老的早期检测和管理为加强IVF治疗策略带来了挑战和机遇。
