Ovarian Reserve Disorders, Can We Prevent Them? A Review

Area of Science:

• Reproductive biology and medicine
• Genetics and developmental biology
• Preventive medicine

Background:

• Ovarian reserve naturally declines from mid-gestation, leading to reduced fertility and potential premature ovarian insufficiency.
• Causes of ovarian reserve depletion are diverse, including genetic, environmental, autoimmune, and iatrogenic factors, often remaining idiopathic.
• Current assisted reproductive technologies may not fully address infertility stemming from diminished ovarian reserve.

Purpose of the Study:

• To explore mechanisms underlying ovarian reserve disorders.
• To emphasize strategies for preventing or mitigating ovarian damage.
• To categorize ovarian reserve disorders from a prevention perspective.

Main Methods:

• Review of existing literature on ovarian reserve and its disorders.
• Exploration of primary, secondary, and tertiary prevention strategies.
• Discussion of proposed mechanisms contributing to ovarian reserve depletion.

Main Results:

• Primary prevention, by identifying and mitigating toxic exposures, is the most effective fertoprotection strategy.
• Secondary prevention (screening) is generally not recommended, except in specific genetic contexts or as part of prenatal care for inherited diseases.
• Tertiary prevention is crucial for managing diagnosed ovarian reserve issues to reduce adverse physiological effects beyond fertility.

Conclusions:

• Understanding the mechanisms of ovarian reserve disorders is key to developing effective fertility treatments.
• A multi-faceted approach to prevention, tailored to individual risk factors, is essential for preserving reproductive health.
• Early diagnosis and intervention can significantly improve outcomes for women experiencing ovarian reserve depletion and related health issues.