Telomere Length Regulation and Reproduction: Current Concepts and Putative Threats To Ovarian Reserve

Introduction

Clinically, ovarian reserve describes a woman's reproductive potential with respect to the number and quality of ovarian follicles she possesses (1–5). Fundamentally, it represents the number of primordial follicles within the ovaries at a given time point—a number that can only accurately be determined by microscopic investigation of the ovaries (6). Declining ovarian reserve with age significantly affects fertility, ultimately resulting in reproductive senescence and the menopause (1–5). In addition to the oocyte loss that occurs with age, a significant increase in meiotic errors occurs in oocytes as women reach their late 30s and 40s (7, 8). This phenomenon contributes to risk of embryonic aneuploidy, miscarriage, and fetal aneuploidy syndromes (4, 7)

(8). Maternal age-related changes in oocyte quantity and quality present a significant challenge to natural fertility and place a limit on the efficacy of infertility treatments (7–10). The complex molecular underpinnings of reproductive senescence are a matter of active investigation with many questions to still be elucidated.

Abstract

Keywords

Infertility, occult ovarian insufficiency, diminished ovarian reserve, oxidative stress, telomere, telomerase