Defining ovarian reserve to better understand ovarian aging

Reproductive Biology and Endocrinology

Review

David H Barad¹  Andrea Weghofer²  Norbert Gleicher³ 

[1] Center for Human Reproduction, New York, New York, NY, USA;Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY, USA;Department of Obstetrics Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA;Center for Human Reproduction, New York, New York, NY, USA;Department of Obstetrics and Gynecology, University of Vienna School of Medicine, Vienna, Austria;Center for Human Reproduction, New York, New York, NY, USA;Foundation for Reproductive Medicine, New York, NY, USA;Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA;

关键词: Follicle Stimulate Hormone;    Ovarian Reserve;    Antral Follicle;    Primordial Follicle;    Oocyte Quality;   

DOI  :  10.1186/1477-7827-9-23

 received in 2011-01-07, accepted in 2011-02-07,  发布年份 2011

来源: Springer

【 摘 要 】

Though a widely utilized term and clinical concept, ovarian reserve (OR) has been only inadequately defined. Based on Medline and PubMed searches we here define OR in its various components, review genetic control of OR, with special emphasis on the FMR1 gene, and discuss whether diminished OR (DOR) is treatable. What is generally referred to as OR reflects only a small portion of total OR (TOR), a pool of growing (recruited) follicles (GFs) at different stages of maturation. Functional OR (FOR) depends on size of the follicle pool at menarche and the follicle recruitment rate. Both vary between individuals and, at least partially, are under genetic control. The FMR1 gene plays a role in defining FOR at all ages. Infertility treatments have in the past almost exclusively only centered on the last two weeks of folliculogenesis, the gonadotropin-sensitive phase. Expansions of treatments into earlier stages of maturation will offer opportunity to significantly improve ovarian stimulation protocols, especially in women with DOR. Dehydroepiandrosterone (DHEA) may represent a first such intervention. Data generated in DHEA-supplemented women, indeed, suggest a new ovarian aging concept, based on aging of ovarian environments and not, as currently is believed, aging oocytes.

【 授权许可】

CC BY   
© Gleicher et al; licensee BioMed Central Ltd. 2011