The Aging Ovary

Abstract

Aging of the human ovary is a continuous process that begins intra utero with the demise of the first crop of oocytes. The process continues throughout life with the relentless attrition of the oocyte's capital through three fundamental events: follicle degeneration or atresia, corpus luteum formation, and transformation of varying cell populations from atretic and luteal complexes into stromal cells. The ultimate consequence of ovarian aging is the modulation of this organ from a follicle-rich, cyclic secretor of estrogen and progesterone to a stroma-rich, noncyclic, low secretor of androgen. Other structural features of the "aged" ovary, such as obliterative arteriolar sclerosis and surface epithelium cysts, indicate that obvious involution is admixed with persisting ovarian activity. It appears, then, that even after the reproductive period has ended, the human ovary is still a viable organ. The contribution of this organ to the overall well-being of the postmenopausal woman remains to be defined.