Age-related fertility decline is a striking phenomenon for women and there is an increasing tendency for later marriage and the postponement of childbearing in industrial countries. Many epidemiological observations also point out that almost one-tenth of reproductive-aged women require infertility treatment in these countries.
Although the uterus is somewhat affected by ageing, the ageing ovary is considered a major but inevitable phenomenon. Consequently, preserving future fecundity is generally understood as preserving ovarian function; this is becoming a major concern for physicians specialized in reproductive medicine. Several chemicals have proved to improve or maintain the ovarian follicular pool, though the efficacy is still limited.
After the publication of the notion that germ cell production finishes in females prior to birth and that the ovarian follicular pool is gradually but irreversibly diminished by the age of 40 to 50, spontaneous exhaustion and deterioration of follicular pool have been attributed to the cause of ovarian ageing. Except for the cryopreservation of eggs that fertilized, oocytes, or ovarian tissue itself, few promising modalities have been established for preservation of the ovarian follicular pool.
Recent advances in assisted reproductive technologies have enabled more efficient cryopreservation of eggs and ovarian tissue. In addition, the concept of ovarian reserve has been introduced in daily clinics and several biomarkers of the ovarian reserve have been developed. Among them, anti-mullerrian hormone is one of the most superior and important marker of ovarian reserve. A statistical model has been proposed to predict the reduction of anti-mullerrian hormone.
Research in ovarian physiology has also revealed novel microenvironment of ovarian follicles. We would like to overview the progress of ovarian function, including follicular pathophysiology, development of ovarian markers, drugs that maintain or improve ovarian reserve, and technologies of cryopreservation of oocyte and ovarian tissues.
Articles that focus on the following sub-topics are of high interest:
_ Novel and recent findings regarding ovarian follicular development;
_ How we measure the ovarian follicle pool mathematically;
_ Follicular pool exhaustion; and
_ The importance of oxidative stress in the ovary.
This collection is the third volume of
Ovarian Ageing: Pathophysiology and Recent Development of Maintaining Ovarian Reserve: Volume II