The ovaries are important organs in women.
The ovaries also age.
When the ovaries are old, not only affect the reproductive function of women, but also cause other related diseases of target organs or systems due to decreased endocrine function.
Many factors will induce ovarian aging, for female friends with fertility plans, if they can understand their ovarian function, they can plan their lives in advance and choose a reasonable timing of fertility.
Predisposing factors for ovarian aging
Ovarian aging is a complex process of multi-factor and multi-link interaction, and its etiology or influencing factors are numerous, and there is no clear classification method. Based on the results of previous studies and the summary literature, we comprehensively summarized the high risk factors for ovarian aging, including age, heredity, hypothalamic-pituitary gland, social psychology, environment, behavior, medical related, immune, infection and endocrine factors.
The environment is a necessary condition for human survival. With the progress of the human age, the increase in social productivity, and the dramatic expansion of the scope and scale of life, the damage to the environment is also increasing. Our study found that chronic systemic daily exposure to PM2.5 can lead to decreased ovarian reserve function. The use of the plant extract knotweed glycosides reduces the inflammatory response and can improve the damage to ovarian function caused by PM2.5 exposure.
Parabens are a common environmental endocrine disruptor that is widely used as a preservative in the cosmetics, food and pharmaceutical industries because it is unavoidable in daily life and has estrogen-like effects. Another of our studies confirmed that Parabens can reach the female follicle fluid and in female mice can lead to significantly lower levels of anti-Miller tube hormone (AMH), obstructed follicle development, and accelerated atresia. It is suggested that daily exposure to Parabens can be harmful to the reproductive health of parents, offspring and multiple generations.
Methods for assessing ovarian reserve
An effective assessment of ovarian reserve can help female friends understand their ovarian function. Due to the different rates of ovarian aging between individuals, the functional state of the ovaries is also different, and the evaluation and protection of the ovaries based on physiological age alone is often not accurate enough. If you can perform ovarian function evaluation tests for female friends, once the ovarian function is found to be reduced, it can be recommended that they change their fertility plans and include pregnancy preparation into the schedule as early as possible, avoiding the regret of unknowing premature ovarian failure but not completing the fertility goal, which is especially important for women who marry late and have children later.
AMH and InhibinB (inhibitor B) have important clinical application value as indicators of ovarian reserve function. However, there is a stratified bias in ovarian function between ethnic groups and geographies. In light of this, we collected blood samples from healthy women of different ages nationwide, culminating in the AMH and Inhibin B reference ranges.
In addition, based on the national multi-center population data and samples, our team detected and verified the mutation sites and X chromosome mutation fragments related to ovarian senescence on a genome-wide scale, screened out 15 gene 41 missense mutation sites with high mutation rate that fully matched the characteristics of the Genetic Background of Han, and integrated X fragility analysis to develop a product suitable for the molecular detection of genetic risk of ovarian function in Chinese women. The positive screening rate of this technology in clinical application is as high as 80%, and it has been promoted and applied in many large medical institutions in Hubei, Zhejiang, Hainan, Fujian, Henan, Guangdong and other places.
Finally, in order to make the assessment more comprehensive, simple and intuitive, we propose the concept of ovarian functional age, that is, to define the age of the ovaries by using the functional state of the ovaries as an evaluation index. We use multi-center, large sample combined with artificial intelligence to integrate physiological, endocrine, and imaging data, joint modeling of multiple indicators, establish an ovarian function calculation model and related factor analysis model, and launch a WeChat service account to accurately quantify ovarian function and achieve early warning of ovarian aging. The model is currently available to medical care and the public free of charge, and the number of users has exceeded 10,000. Clinical practice shows that this model can accurately assess the patient's ovarian functional age and predict the age of menopause, which is helpful for formulating a reasonable birth plan and career plan for the patient.
The researchers say
Ovarian aging is an emerging and important area of research
In 1999, China entered an aging society.
In 2002, while doing postdoctoral research in tumor immunology at the University of Texas southwestern medical center in Dallas, I was deeply attracted by a lecture on the latest research on aging. I learned that aging is a pathological process that can cause the occurrence and development of a series of related diseases, and Alzheimer's disease, cardiovascular disease, and even cancer are all related to aging.
In 2004, after returning to China, my team and I launched an exploration of ovarian aging. At that time, there were not many people studying ovarian aging worldwide, and there were very few articles and reports about it, and even what "ovarian aging" was not clearly defined. Fortunately, the Human Genome Project has been completed, and the level of medical research has gone from systems and organs, to tissues and cells, to genetic and molecular levels. The academic background of clinical and basic research on gynecological tumors allows us to examine and analyze the nature and internal laws of ovarian aging from different perspectives.
Over the past ten years, we have explored the causes and influencing factors of ovarian aging, excavated the internal mechanism of ovarian aging, initially established the evaluation standards and early warning system of ovarian function in Chinese women, and systematically studied the strategies, methods and drugs for protecting ovarian function. All of this is written about in the medical monograph "Ovarian Aging".
The ovaries, as one of the many organs of the body, age. The core of ovarian aging is the process of ovarian function from strong to decay, and then to failure. The "life cycle of the ovaries" goes through birth, development, maturation, decline, and exhaustion. Ovarian aging not only causes menopause and its syndrome, but is actually an important process that occurs earlier, continues to decline, and involves a wider range.
Ovarian aging is an extremely complex process with many causes or influencing factors, and there is no clear classification. To this end, based on the concept of precision medicine, the team refers to the important conclusions of internal and external factors in the contradiction theory, and divides the influencing factors of ovarian aging into ten categories, such as genetic factors, environmental factors, and behavioral factors, so as to further study in depth. At the same time, the pathophysiology and molecular biology mechanisms of ovarian aging caused by the above factors are systematically sorted out and classified.
Correct diagnosis of the disease is the cornerstone of proper treatment. Finally, we elaborated on the key indicators of ovarian aging assessment and the construction and improvement of their early warning system, and put forward three major concepts of intervenorial aging and seven strategies for clinical management, and also boldly put forward new understandings and suggestions on how to scientifically maintain, maintain or protect ovarian functions in daily life or medical process.
Author: Department of Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wang Shixuan, Luo Aiyue
Planner: Fang Tong
Editor: Yingpan Zheng