Understanding oocyte ageing: can we influence the process as clinicians?

Area of Science:

• Reproductive biology
• Mitochondrial medicine
• Gerontology

Background:

• Oocyte quality is crucial for pregnancy success and declines with advanced maternal age.
• Oocyte aging is linked to mitochondrial dysfunction and increased oxidative stress.
• Key quality-defining events occur during oocyte growth over several months.

Purpose of the Study:

• To review animal study evidence on mitochondrial nutrients reversing oocyte aging.
• To explore clinical evidence for mitochondrial nutrient usage in improving oocyte quality.
• To identify optimal strategies for evaluating these therapeutics in humans.

Main Methods:

• Review of animal studies on mitochondrial modifiers (e.g., CoQ10) and NAD+.
• Analysis of existing clinical trial data and study designs.
• Comparison of treatment timing and patient selection in human studies versus animal models.

Main Results:

• Animal studies demonstrate that mitochondrial nutrients can reverse oocyte aging.
• NAD+ boosting and CoQ10 treatment improved oocyte quality in mice during their growth phase.
• Clinical evidence for reproducible improvements in human oocyte quality is currently lacking.

Conclusions:

• Mitochondrial therapeutics, particularly NAD+-boosting agents, show potential for rejuvenating aged oocytes.
• Human trials should target patients with poor oocyte quality and use per-oocyte endpoints.
• Adequate treatment duration capturing the oocyte growth phase is critical for evaluating efficacy.