Ovarian Aging: Mechanisms and Clinical Consequences
| Autor: | Bart C.J.M. Fauser, F. J. Broekmans, M. R. Soules |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
CITRATE CHALLENGE TEST
Aging ANTI-MULLERIAN HORMONE Endocrinology Diabetes and Metabolism medicine.medical_treatment media_common.quotation_subject Physiology Fertility ASSISTED REPRODUCTIVE TECHNOLOGIES METABOLIZING GENE POLYMORPHISMS INHIBITING SUBSTANCE LEVELS Andrology Endocrinology Pregnancy Endocrine Glands IN-VITRO-FERTILIZATION medicine Humans Ovarian reserve Menstrual Cycle media_common GONADOTROPIN-RELEASING-HORMONE Assisted reproductive technology In vitro fertilisation biology Ovary Anti-Müllerian hormone RANDOMIZED CONTROLLED-TRIAL FOLLICLE-STIMULATING-HORMONE medicine.disease Antral follicle HUMAN MENSTRUAL-CYCLE Menopause Oocytes biology.protein Female Folliculogenesis Biomarkers |
| Zdroj: | Endocrine Reviews. 30:465-493 |
| ISSN: | 1945-7189 0163-769X |
| Popis: | Menopause is the final step in the process referred to as ovarian ageing. The age related decrease in follicle numbers dictates the onset of cycle irregularity and the final cessation of menses. The parallel decay in oocyte quality contributes to the gradual decline in fertility and the final occurrence of natural sterility. Endocrine changes mainly relate to the decline in the negative feedback from ovarian factors at the hypothalamo-pituitary unit. The declining cohort of antral follicles with age first results in gradually elevated FSH levels, followed by subsequent stages of overt cycle irregularity. The gradual decline in the size of the antral follicle cohort is best represented by decreasing levels of anti-Mullerian hormone. The variability of ovarian ageing among women is evident from the large variation in age at menopause. The identification of women who have severely decreased ovarian reserve for their age is clinically relevant. Ovarian reserve tests have appeared to be fairly accurate in predicting response to ovarian stimulation in the assisted reproductive technology (ART) setting. The capacity to predict the chances for spontaneous pregnancy or pregnancy after ART appears very limited. As menopause and the preceding decline in oocyte quality seem to have a fixed time interval, tests that predict the age at menopause may be useful to assess individual reproductive lifespan. Especially genetic studies, both addressing candidate gene and genome wide association, have identified several interesting loci of small genetic variation that may determine fetal follicle pool development and subsequent wastage of his pool over time. Improved knowledge of the ovarian ageing mechanisms may ultimately provide tools for prediction of menopause and manipulation of the early steps of folliculogenesis for the purpose of contraception and fertility lifespan extension. (Endocrine Reviews 30: 465-493, 2009) |
| Databáze: | OpenAIRE |
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