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Ovarian aging in humans: potential strategies for extending reproductive lifespan

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Abstract

Ovarian reserve is a term used to estimate the total number of immature follicles present in the ovaries. Between birth and menopause, there is a progressive decrease in the number of ovarian follicles. Ovarian aging is a continuous physiological phenomenon, with menopause being the clinical mark of the end of ovarian function. Genetics, measured as family history for age at the onset of menopause, is the main determinant. However, physical activity, diet, and lifestyle are important factors that can influence the age of menopause. The low estrogen levels after natural or premature menopause increased the risk for several diseases, resulting in increased mortality risk. Besides that, the decreasing ovarian reserve is associated to reduced fertility. In women with infertility undergoing in vitro fertilization, reduced markers of ovarian reserve, including antral follicular count and anti-Mullerian hormone, are the main indicators of reduced chances of becoming pregnant. Therefore, it becomes clear that the ovarian reserve has a central role in women’s life, affecting fertility early in life and overall health later in life. Based on this, the ideal strategy for delaying ovarian aging should have the following characteristics: (1) be initiated in the presence of good ovarian reserve; (2) maintained for a long period; (3) have an action on the dynamics of primordial follicles, controlling the rate of activation and atresia; and (4) safe use in pre-conception, pregnancy, and lactation. In this review, we therefore discuss some of these strategies and its feasibility for preventing a decline in the ovarian reserve.

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Funding

FUNCAP PS1-0186–00240.01.00/21; UNIFOR 60/2022; CAPES; CNPq; FAPERGS; NIH/NIA R56AG074499.

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Authors and Affiliations

  1. Postgraduate Program in Medical Sciences, University of Fortaleza (UNIFOR), Fortaleza, CE, 60.811-905, Brazil

    Marcelo Borges Cavalcante, Olga Goiana Martins Sampaio & Fernanda Eunice Araújo Câmara

  2. Nutrition College, Federal University of Pelotas (UFPel), Pelotas, RS, 96010-610, Brazil

    Augusto Schneider, Bianca Machado de Ávila & Juliane Prosczek

  3. Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando FL, USA

    Michal M. Masternak

  4. Department of Head and Neck Surgery, Poznan University of Medical Sciences, Poznan, Poland

    Michal M. Masternak & Adriana Rolim Campos

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  1. Marcelo Borges Cavalcante
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Cavalcante, M.B., Sampaio, O.G.M., Câmara, F.E.A. et al. Ovarian aging in humans: potential strategies for extending reproductive lifespan. GeroScience 45, 2121–2133 (2023). https://doi.org/10.1007/s11357-023-00768-8

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