Abstract
Ovarian reserve and its utilization, over a reproductive life span, are determined
by genetic, epigenetic, and environmental factors. The establishment of the primordial
follicle pool and the rate of primordial follicle activation have been under intense
study to determine genetic factors that affect reproductive lifespan. Much has been
learned from transgenic animal models about the developmental origins of the primordial
follicle pool and mechanisms that lead to primordial follicle activation, folliculogenesis,
and the maturation of a single oocyte with each menstrual cycle. Recent genome-wide
association studies on the age of human menopause have identified approximately 20
loci, and shown the importance of factors involved in double-strand break repair and
immunology. Studies to date from animal models and humans show that many genes determine
ovarian aging, and that there is no single dominant allele yet responsible for depletion
of the ovarian reserve. Personalized genomic approaches will need to take into account
the high degree of genetic heterogeneity, family pedigree, and functional data of
the genes critical at various stages of ovarian development to predict women's reproductive
life span.
Keywords
ovarian reserve - menopause - premature ovarian failure