The process of ovarian aging: it is not just about oocytes and granulosa cells.

Abstract

Ovarian age is classically considered the main cause of female reproductive infertility. In women, the process proceeds as an ongoing decline in the primordial follicle stockpile and it is associated with reduced fertility in the mid-thirties, irregular menstruation from the mid-forties, cessation of fertility, and, eventually, menopause in the early fifties. Reproductive aging is historically associated with changes in oocyte quantity and quality. However, besides theoocyte, other cellular as well as environmental factorshave been the focus of more recent investigations suggesting that ovarian decay is acomplex and multifacetedprocess. Among these factors, we will consider mitochondria and oxidative stress as related to nutrition, changes in extracellular matrix molecules, and the associated ovarianstromal compartment where immune cellsof both the native and adaptive systems seem to play an important role. Understanding such processes is crucial to design treatment strategies to slow down ovarian aging and consequently prolong reproductive lifespan and, more to this, alleviaingt side effects of menopause on themusculoskeletal, cardiovascular, and nervous systems.