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Updated: Mar 7, 2026

Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Stimulation of ovarian follicle growth after AMPK inhibition
Xiaowei Lu1,2, Song Guo1, Yuan Cheng2
1Department of Obstetrics and GynecologyCenter of Reproductive Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China ssmuirl@163.com artruijinyunfeng@163.com.
Abstract:
Previous studies showed that the protein kinase B (Akt)-mammalian target of rapamycin (mTOR) and Hippo signaling Yes-associated protein (YAP) pathways play important roles in promoting follicle growth. Additionally, other studies demonstrated that 5' adenosine monophosphate-activated protein kinase (AMPK) is an upstream regulatory element of mTOR and YAP. Here, we used AMPK inhibitor (Compound C) to in vitro cultured ovaries from 10-day-old mice followed by in vivo grafting into adult hosts or to in situ treated ovaries of 3-week-old mice by intrabursal injection followed by gonadotropin stimulation. We found that the phosphorylation of ovarian mTOR and downstream proteins (ribosomal protein S6 (S6) and eukaryotic translation initiation factor 4B (eIF4B)) was upregulated following Compound C administration, whereas tuberous sclerosis complex 2 (TSC2) phosphorylation was downregulated. Additionally, treatment with Compound C increased hypoxia-inducible factor 1-alpha (Hif1a), vascular endothelial growth factor A (Vegfa), VEGF receptor 2 (Vegfr2) and connective tissue growth factor (Ctgf) mRNA levels. Furthermore, treatment of 10-day-old mice with Compound C promoted the growth of preantral and antral follicles accompanied by enhanced angiogenesis. In situ intrabursal injection with Compound C, followed by controlled ovarian hyperstimulation, increased the number of ovulated oocytes in 3-week-old mice, and these oocytes could be successfully fertilized, leading to the delivery of healthy pups. Our results demonstrated that treatment with AMPK inhibitor resulted in the activation of the mTOR signaling pathway, increases in Ctgf expression in mouse ovaries, stimulation of follicle development and promotion of ovarian angiogenesis for ovary growth.
Insights
Inhibiting 5' adenosine monophosphate-activated protein kinase (AMPK) in mouse ovaries activates the mTOR pathway, promoting follicle growth and ovarian angiogenesis, leading to successful reproduction.
Area of Science:
- Reproductive Biology
- Molecular Endocrinology
- Developmental Biology
Background:
- Protein kinase B (Akt)-mammalian target of rapamycin (mTOR) and Hippo signaling Yes-associated protein (YAP) pathways are crucial for ovarian follicle development.
- 5' adenosine monophosphate-activated protein kinase (AMPK) acts as an upstream regulator for both mTOR and YAP signaling pathways.
Purpose of the Study:
- To investigate the effect of inhibiting AMPK on ovarian follicle growth, angiogenesis, and reproductive outcomes in mice.
- To elucidate the molecular mechanisms underlying AMPK inhibition's impact on key signaling pathways in the ovary.
Main Methods:
- Ovaries from 10-day-old mice were cultured in vitro with an AMPK inhibitor (Compound C) followed by in vivo grafting.
- Ovaries from 3-week-old mice were treated in situ with Compound C via intrabursal injection, followed by gonadotropin stimulation.
- Analysis of signaling pathway phosphorylation (mTOR, S6, eIF4B, TSC2) and gene expression (Hif1a, Vegfa, Vegfr2, Ctgf) was performed.
Main Results:
- Compound C treatment upregulated ovarian mTOR signaling and increased Ctgf mRNA levels, while downregulating TSC2 phosphorylation.
- Inhibition of AMPK promoted preantral and antral follicle growth and enhanced ovarian angiogenesis.
- In situ treatment resulted in increased oocyte ovulation, successful fertilization, and the birth of healthy pups.
Conclusions:
- AMPK inhibition activates the mTOR pathway and stimulates ovarian follicle development and angiogenesis in mice.
- This study demonstrates a novel therapeutic strategy for enhancing ovarian function and reproductive potential through AMPK inhibition.
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