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Touraine P, Chabbert-Buffet N, Plu-Bureau G, Duranteau L, Sinclair AH, Tucker EJ. Premature ovarian insufficiency. Nat Rev Dis Primers 2024; 10:63. [PMID: 39266563 DOI: 10.1038/s41572-024-00547-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 09/14/2024]
Abstract
Premature ovarian insufficiency (POI) is a cause of infertility and endocrine dysfunction in women, defined by loss of normal, predictable ovarian activity before the age of 40 years. POI is clinically characterized by amenorrhoea (primary or secondary) with raised circulating levels of follicle-stimulating hormone. This condition can occur due to medical interventions such as ovarian surgery or cytotoxic cancer therapy, metabolic and lysosomal storage diseases, infections, chromosomal anomalies and autoimmune diseases. At least 1 in 100 women is affected by POI, including 1 in 1,000 before the age of 30 years. Substantial evidence suggests a genetic basis to POI. However, the cause of idiopathic POI remains unknown in most patients, indicating that gene variants associated with this condition remain to be discovered. Over the past 10 years, tremendous progress has been made in our knowledge of genes involved in POI. Genetic approaches in diagnosis are important as they enable patients with familial POI to be identified, with the opportunity for oocyte preservation. Moreover, genetic approaches could provide a better understanding of disease mechanisms, which will ultimately aid the development of improved treatments.
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Affiliation(s)
- Philippe Touraine
- Department of Endocrinology and Reproductive Medicine, AP-HP Pitié Salpêtrière Hospital, Sorbonne Université Médecine, Paris, France.
- Inserm U1151 INEM, Necker Hospital, Paris, France.
| | - Nathalie Chabbert-Buffet
- Department of Obstetrics, Gynecology and Reproductive Medicine, Tenon Hospital, AP-HP Sorbonne Université, Paris, France
- INSERM UMR S 938, CDR St Antoine, Paris, France
| | - Genevieve Plu-Bureau
- Department of Medical Gynecology, AP-HP Port Royal-Cochin Hospital, Université Paris Cité, Paris, France
- U1151 EPOPEE Team, Paris, France
| | - Lise Duranteau
- Department of Medical Gynecology, Bicêtre Hospital, AP-HP Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Andrew H Sinclair
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Elena J Tucker
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
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Gong L, Hou J, Yang H, Zhang X, Zhao J, Wang L, Yin X, Feng X, Yin C. Kuntai capsule attenuates premature ovarian insufficiency by activating the FOXO3/SIRT5 signaling pathway in mice: A comprehensive study using UHPLC-LTQ-Orbitrap and integrated pharmacology. JOURNAL OF ETHNOPHARMACOLOGY 2024; 322:117625. [PMID: 38145859 DOI: 10.1016/j.jep.2023.117625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Classical prescriptions are not only a primary method of clinical treatment in traditional Chinese medicine (TCM) but also represent breakthroughs in the inheritance and development of this field. Kuntai capsule (KTC), a formulation based on a classical prescription, comprises six TCMs: Rehmanniae Radix Praeparata, Coptidis Rhizoma, Paeoniae Radix Alba, Scutellariae Radix, Asini Corii Colla, and Poria. This formulation possesses various beneficial effects, such as nourishing yin and blood, clearing heat and purging fire, and calming the nerves and relieving annoyance. The investigation of the efficacy and mechanism of KTC in regulating anti-aging factors in the treatment of premature ovarian insufficiency (POI) is not only a prominent topic in classical prescription research but also a crucial issue in the treatment of female reproductive aging using TCM. AIM OF THE STUDY To evaluate the therapeutic effect of KTC on POI and its underlying mechanism. MATERIALS AND METHODS Healthy and specific pathogen-free (SPF) female Kunming mice aged 6-8 weeks were selected. After acclimatization, the mice were randomly divided into a control, model, and high, middle, and low dose groups of KTC (1.6, 0.8, and 0.4 mg/kg, respectively). Except for the control group, the animals in the other groups were administered a single intraperitoneal injection of 120 mg/kg cyclophosphamide and 30 mg/kg Busulfan to induce the model of POI. After modeling, the mice were treated with the corresponding drugs for 7 days. Serum and ovarian tissues were collected, and the levels of serum follicle-stimulating hormone (FSH), estradiol (E2), and superoxide dismutase 2 (SOD2) were determined using enzyme-linked immunosorbent assay (ELISA). The chemical composition of KTC was characterized and analyzed using ultra-high-pressure liquid chromatography-linear ion trap-Orbitrap tandem mass spectrometry. A "drug-component-target-pathway-disease" network was constructed using network pharmacology research methods to identify the key active components of KTC in treating POI and to elucidate its potential mechanism. The protein expression of the FOXO3/SIRT5 pathway was detected by western blotting. RESULTS Compared to the model group, the high-dose group of KTC showed a significant increase in ovarian index, significant increase in levels of E2 and SOD2, and a significant decrease in FSH levels. Through systematic analysis of the chemical constituents of KTC, 69 compounds were identified, including 7 organic acids, 14 alkaloids, 28 flavonoids, 15 terpenoids, 2 lignans, 2 phenylpropanoids, and 1 sugar. Based on network pharmacology research methods, it was determined that KTC exerts its therapeutic effect on POI through multiple components (paeoniflorin and malic acid), multiple targets (FOXO3 and SIRT5), and multiple pathways (prolactin signaling pathway, longevity regulating pathway, and metabolic pathways). The accuracy of the network pharmacology prediction was further validated by detecting the protein expression of SIRT5 and FOXO3a, which showed a significant increase in the middle and high-dose groups of KTC compared to the model group. CONCLUSIONS KTC may effectively treat POI through a multi-component, multi-target, multi-pathway approach, providing an experimental basis for using KTC based on classical prescriptions in the treatment of POI.
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Affiliation(s)
- Leilei Gong
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Jinli Hou
- Modern Research Center for Traditional Chinese Medicine, The Key Laboratory of Chemical Biology and Molecular Engineering of Ministry of Education, Shanxi University, Taiyuan, 030006, China.
| | - Hongjun Yang
- China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Xueyan Zhang
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Jingxia Zhao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
| | - Lan Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Xiaojie Yin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Xin Feng
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Chenghong Yin
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
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Mbarek H, Gordon SD, Duffy DL, Hubers N, Mortlock S, Beck JJ, Hottenga JJ, Pool R, Dolan CV, Actkins KV, Gerring ZF, Van Dongen J, Ehli EA, Iacono WG, Mcgue M, Chasman DI, Gallagher CS, Schilit SLP, Morton CC, Paré G, Willemsen G, Whiteman DC, Olsen CM, Derom C, Vlietinck R, Gudbjartsson D, Cannon-Albright L, Krapohl E, Plomin R, Magnusson PKE, Pedersen NL, Hysi P, Mangino M, Spector TD, Palviainen T, Milaneschi Y, Penninnx BW, Campos AI, Ong KK, Perry JRB, Lambalk CB, Kaprio J, Ólafsson Í, Duroure K, Revenu C, Rentería ME, Yengo L, Davis L, Derks EM, Medland SE, Stefansson H, Stefansson K, Del Bene F, Reversade B, Montgomery GW, Boomsma DI, Martin NG. Genome-wide association study meta-analysis of dizygotic twinning illuminates genetic regulation of female fecundity. Hum Reprod 2024; 39:240-257. [PMID: 38052102 PMCID: PMC10767824 DOI: 10.1093/humrep/dead247] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/14/2023] [Indexed: 12/07/2023] Open
Abstract
STUDY QUESTION Which genetic factors regulate female propensity for giving birth to spontaneous dizygotic (DZ) twins? SUMMARY ANSWER We identified four new loci, GNRH1, FSHR, ZFPM1, and IPO8, in addition to previously identified loci, FSHB and SMAD3. WHAT IS KNOWN ALREADY The propensity to give birth to DZ twins runs in families. Earlier, we reported that FSHB and SMAD3 as associated with DZ twinning and female fertility measures. STUDY DESIGN, SIZE, DURATION We conducted a genome-wide association meta-analysis (GWAMA) of mothers of spontaneous dizygotic (DZ) twins (8265 cases, 264 567 controls) and of independent DZ twin offspring (26 252 cases, 417 433 controls). PARTICIPANTS/MATERIALS, SETTING, METHODS Over 700 000 mothers of DZ twins, twin individuals and singletons from large cohorts in Australia/New Zealand, Europe, and the USA were carefully screened to exclude twins born after use of ARTs. Genetic association analyses by cohort were followed by meta-analysis, phenome wide association studies (PheWAS), in silico and in vivo annotations, and Zebrafish functional validation. MAIN RESULTS AND THE ROLE OF CHANCE This study enlarges the sample size considerably from previous efforts, finding four genome-wide significant loci, including two novel signals and a further two novel genes that are implicated by gene level enrichment analyses. The novel loci, GNRH1 and FSHR, have well-established roles in female reproduction whereas ZFPM1 and IPO8 have not previously been implicated in female fertility. We found significant genetic correlations with multiple aspects of female reproduction and body size as well as evidence for significant selection against DZ twinning during human evolution. The 26 top single nucleotide polymorphisms (SNPs) from our GWAMA in European-origin participants weakly predicted the crude twinning rates in 47 non-European populations (r = 0.23 between risk score and population prevalence, s.e. 0.11, 1-tail P = 0.058) indicating that genome-wide association studies (GWAS) are needed in African and Asian populations to explore the causes of their respectively high and low DZ twinning rates. In vivo functional tests in zebrafish for IPO8 validated its essential role in female, but not male, fertility. In most regions, risk SNPs linked to known expression quantitative trait loci (eQTLs). Top SNPs were associated with in vivo reproductive hormone levels with the top pathways including hormone ligand binding receptors and the ovulation cycle. LARGE SCALE DATA The full DZT GWAS summary statistics will made available after publication through the GWAS catalog (https://www.ebi.ac.uk/gwas/). LIMITATIONS, REASONS FOR CAUTION Our study only included European ancestry cohorts. Inclusion of data from Africa (with the highest twining rate) and Asia (with the lowest rate) would illuminate further the biology of twinning and female fertility. WIDER IMPLICATIONS OF THE FINDINGS About one in 40 babies born in the world is a twin and there is much speculation on why twinning runs in families. We hope our results will inform investigations of ovarian response in new and existing ARTs and the causes of female infertility. STUDY FUNDING/COMPETING INTEREST(S) Support for the Netherlands Twin Register came from the Netherlands Organization for Scientific Research (NWO) and The Netherlands Organization for Health Research and Development (ZonMW) grants, 904-61-193, 480-04-004, 400-05-717, Addiction-31160008, 911-09-032, Biobanking and Biomolecular Resources Research Infrastructure (BBMRI.NL, 184.021.007), Royal Netherlands Academy of Science Professor Award (PAH/6635) to DIB, European Research Council (ERC-230374), Rutgers University Cell and DNA Repository (NIMH U24 MH068457-06), the Avera Institute, Sioux Falls, South Dakota (USA) and the National Institutes of Health (NIH R01 HD042157-01A1) and the Genetic Association Information Network (GAIN) of the Foundation for the National Institutes of Health and Grand Opportunity grants 1RC2 MH089951. The QIMR Berghofer Medical Research Institute (QIMR) study was supported by grants from the National Health and Medical Research Council (NHMRC) of Australia (241944, 339462, 389927, 389875, 389891, 389892, 389938, 443036, 442915, 442981, 496610, 496739, 552485, 552498, 1050208, 1075175). L.Y. is funded by Australian Research Council (Grant number DE200100425). The Minnesota Center for Twin and Family Research (MCTFR) was supported in part by USPHS Grants from the National Institute on Alcohol Abuse and Alcoholism (AA09367 and AA11886) and the National Institute on Drug Abuse (DA05147, DA13240, and DA024417). The Women's Genome Health Study (WGHS) was funded by the National Heart, Lung, and Blood Institute (HL043851 and HL080467) and the National Cancer Institute (CA047988 and UM1CA182913), with support for genotyping provided by Amgen. Data collection in the Finnish Twin Registry has been supported by the Wellcome Trust Sanger Institute, the Broad Institute, ENGAGE-European Network for Genetic and Genomic Epidemiology, FP7-HEALTH-F4-2007, grant agreement number 201413, National Institute of Alcohol Abuse and Alcoholism (grants AA-12502, AA-00145, AA-09203, AA15416, and K02AA018755) and the Academy of Finland (grants 100499, 205585, 118555, 141054, 264146, 308248, 312073 and 336823 to J. Kaprio). TwinsUK is funded by the Wellcome Trust, Medical Research Council, Versus Arthritis, European Union Horizon 2020, Chronic Disease Research Foundation (CDRF), Zoe Ltd and the National Institute for Health Research (NIHR) Clinical Research Network (CRN) and Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust in partnership with King's College London. For NESDA, funding was obtained from the Netherlands Organization for Scientific Research (Geestkracht program grant 10000-1002), the Center for Medical Systems Biology (CSMB, NVVO Genomics), Biobanking and Biomolecular Resources Research Infrastructure (BBMRI-NL), VU University's Institutes for Health and Care Research (EMGO+) and Neuroscience Campus Amsterdam, University Medical Center Groningen, Leiden University Medical Center, National Institutes of Health (NIH, ROI D0042157-01A, MH081802, Grand Opportunity grants 1 RC2 Ml-1089951 and IRC2 MH089995). Part of the genotyping and analyses were funded by the Genetic Association Information Network (GAIN) of the Foundation for the National Institutes of Health. Computing was supported by BiG Grid, the Dutch e-Science Grid, which is financially supported by NWO. Work in the Del Bene lab was supported by the Programme Investissements d'Avenir IHU FOReSIGHT (ANR-18-IAHU-01). C.R. was supported by an EU Horizon 2020 Marie Skłodowska-Curie Action fellowship (H2020-MSCA-IF-2014 #661527). H.S. and K.S. are employees of deCODE Genetics/Amgen. The other authors declare no competing financial interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Hamdi Mbarek
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
- Qatar Genome Program, Qatar Foundation, Doha, Qatar
- Amsterdam Reproduction and Development Institute, Amsterdam, The Netherlands
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - David L Duffy
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Nikki Hubers
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Institute, Amsterdam, The Netherlands
| | - Sally Mortlock
- Institute of Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Jeffrey J Beck
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, SD, USA
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | - René Pool
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | - Conor V Dolan
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ky’Era V Actkins
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | | | - Jenny Van Dongen
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Institute, Amsterdam, The Netherlands
| | - Erik A Ehli
- Avera Institute for Human Genetics, Avera McKennan Hospital and University Health Center, Sioux Falls, SD, USA
| | - William G Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Matt Mcgue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel I Chasman
- Harvard Medical School, Harvard University, Boston, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Samantha L P Schilit
- Harvard Medical School, Harvard University, Boston, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Cynthia C Morton
- Harvard Medical School, Harvard University, Boston, MA, USA
- Brigham and Women’s Hospital, Boston, MA, USA
| | - Guillaume Paré
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Gonneke Willemsen
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
| | | | | | | | | | | | | | - Eva Krapohl
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Statistical Sciences & Innovation, UCB Biosciences GmbH, Monheim, Germany
| | - Robert Plomin
- Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pirro Hysi
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, UK
| | - Massimo Mangino
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, UK
- NIHR Biomedical Research Centre at Guy’s and St Thomas’ Foundation Trust, London, UK
| | - Timothy D Spector
- Department of Twin Research & Genetic Epidemiology, King’s College London, London, UK
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Yuri Milaneschi
- Department of Psychiatry, EMGO Institute for Health and Care Research, Vrije Universiteit, Amsterdam, The Netherlands
| | - Brenda W Penninnx
- Department of Psychiatry, EMGO Institute for Health and Care Research, Vrije Universiteit, Amsterdam, The Netherlands
| | - Adrian I Campos
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Institute of Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Ken K Ong
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - John R B Perry
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK
| | - Cornelis B Lambalk
- Amsterdam Reproduction and Development Institute, Amsterdam, The Netherlands
- Amsterdam University Medical Centers Location VU Medical Center, Amsterdam, The Netherlands
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
| | - Ísleifur Ólafsson
- Department of Clinical Biochemistry, National University Hospital of Iceland, Reykjavik, Iceland
| | - Karine Duroure
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Céline Revenu
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Loic Yengo
- Institute of Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Lea Davis
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | - Eske M Derks
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | | | | | - Filippo Del Bene
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Bruno Reversade
- Genome Institute of Singapore, Laboratory of Human Genetics & Therapeutics, A*STAR, Singapore, Singapore
- Smart-Health Initiative, BESE, KAUST, Thuwal, Saudi Arabia
| | - Grant W Montgomery
- Institute of Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Dorret I Boomsma
- Department of Biological Psychology, Netherlands Twin Register, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Institute, Amsterdam, The Netherlands
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Xu C, Ruan X, Mueck AO. Progress in genome-wide association studies of age at natural menopause. Reprod Biomed Online 2023; 46:607-622. [PMID: 36572578 DOI: 10.1016/j.rbmo.2022.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/09/2022] [Accepted: 11/28/2022] [Indexed: 12/09/2022]
Abstract
Menopause is not only the end of reproductive life, it is also related to diseases such as hyperlipidaemia, atherosclerotic cardiovascular disease, osteoporosis and breast cancer. Traditional epidemiological studies have found that heredity is the main determinant of age at natural menopause (ANM). Early studies on genetic factors were limited to candidate gene studies. Menopause age is not inherited by a single gene, but is the result of multiple gene effects. With the development of genomic technology, the Reproductive Genetics Consortium conducted several genome-wide association studies on ANM in people of European descent, and found that defects in DNA damage repair pathways were the main genetic mechanism. In recent years, due to the ethnic heterogeneity of ANM, there has been further development of global studies into multi-ethnic and trans-ethnic genome-wide association studies. Further genetic and epidemiological studies, including polygenetic score and genetic mechanism research, should be conducted to investigate the pathogenesis and mechanism with respect to menopause and its related diseases.
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Affiliation(s)
- Che Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University; Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University; Beijing Maternal and Child Health Care Hospital, Beijing, China; University Women's Hospital and Research Centre for Women's Health, Department for Women's Health, University of Tuebingen, Tuebingen, Germany.
| | - Alfred O Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University; Beijing Maternal and Child Health Care Hospital, Beijing, China; University Women's Hospital and Research Centre for Women's Health, Department for Women's Health, University of Tuebingen, Tuebingen, Germany
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In vitro germ cell induction from fertile and infertile monozygotic twin research participants. Cell Rep Med 2022; 3:100782. [PMID: 36260988 PMCID: PMC9589117 DOI: 10.1016/j.xcrm.2022.100782] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/23/2022] [Accepted: 09/22/2022] [Indexed: 11/08/2022]
Abstract
Human induced pluripotent stem cells (hiPSCs) enable reproductive diseases to be studied when the reproductive health of the participant is known. In this study, monozygotic (MZ) monoamniotic (MA) twins discordant for primary ovarian insufficiency (POI) consent to research to address the hypothesis that discordant POI is due to a shared primordial germ cell (PGC) progenitor pool. If this is the case, reprogramming the twin's skin cells to hiPSCs is expected to restore equivalent germ cell competency to the twins hiPSCs. Following reprogramming, the infertile MA twin's cells are capable of generating human PGC-like cells (hPGCLCs) and amniotic sac-like structures equivalent to her fertile twin sister. Using these hiPSCs together with genome sequencing, our data suggest that POI in the infertile twin is not due to a genetic barrier to amnion or germ cell formation and support the hypothesis that during gestation, amniotic PGCs are likely disproportionately allocated to the fertile twin with embryo splitting.
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Silvén H, Savukoski SM, Pesonen P, Pukkala E, Gissler M, Suvanto E, Niinimäki M. Incidence and familial risk of premature ovarian insufficiency in the Finnish female population. Hum Reprod 2022; 37:1030-1036. [PMID: 35134918 PMCID: PMC9071220 DOI: 10.1093/humrep/deac014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION What is the incidence of premature ovarian insufficiency (POI), has the incidence of POI changed over time, and what is the risk of POI among relatives of POI women? SUMMARY ANSWER The incidence of POI increased among females aged 15-19 years from 2007 onwards and decreased in older age groups, and among relatives of women with POI the risk of POI is significantly increased. WHAT IS KNOWN ALREADY So far, there has been no good quality, nationwide studies of the incidence of POI. Early menopause has been associated with the elevated risk of early menopause among relatives, but the knowledge of the familial risk of POI is scarce. Lower socioeconomic status has been associated with lower age at natural menopause. STUDY DESIGN, SIZE, DURATION Population-based study with 5011 women diagnosed with POI in 1988-2017. The data were collected from national registries and covers POI subjects in entire Finland. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with hormone replacement therapy reimbursement for POI were identified from Social Insurance Institution (SII). We calculated POI incidence in different age groups and studied the changes in the incidence rate over time in 5-year segments. Four population-based controls were selected from the Digital and Population Data Services Agency (DVV) for each POI woman. Family members of the POI cases and controls were identified from the DVV and linked to SII reimbursement data to identify POI diagnoses among them. The familial risk of POI was estimated with a logistical regression model. MAIN RESULTS AND THE ROLE OF CHANCE The incidence was highest in the 35-39 age group, ranging from 73.8/100 000 women-years in 1993-1997 to 39.9/100 000 women-years in 2013-2017. From 2007, the incidence among 15- to 19-year-olds rose from 7.0 to 10.0/100 000 women-years in 2015-2017. Cumulative incidence of POI for women under 40 years in 1988-2017 was 478/100 000 women. The relative risk of POI among relatives of women with POI was 4.6 (95% CI 3.3-6.5) compared to relatives of women without POI. POI women tended to have slightly lower socioeconomic status and level of education compared to controls. LIMITATIONS, REASONS FOR CAUTION For some women with POI, diagnosis or reimbursement may be lacking. However, we presume that these women represent a minority due to the nature of the disease and the economic benefits of reimbursement. Some changes in the incidence of POI can reflect changes in clinical practice and changing treatments and reimbursement criteria. WIDER IMPLICATIONS OF THE FINDINGS The risk of developing POI is significantly higher in women who have first-degree relatives diagnosed with POI. Raising awareness of the increased risk might lead to earlier diagnosis and initiation of hormonal replacement therapy, possibly preventing adverse effects of low oestrogen levels, such as osteoporosis. STUDY FUNDING/COMPETING INTEREST(S) This work was financially supported by the Oulu University Hospital. H.S. received a grant from Finnish Menopause Society. S.M.S. received a grant from the Finnish Menopause Society, the Finnish Medical Foundation and the Juho Vainio Foundation. The authors do not have any competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- H Silvén
- Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - S M Savukoski
- Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - P Pesonen
- Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - E Pukkala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - M Gissler
- Information Services Department, THL Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, 171 76, Karolinska Institute, Stockholm, Sweden
| | - E Suvanto
- Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - M Niinimäki
- Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
- PEDEGO Research Unit, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
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7
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Stuenkel CA, Gompel A, Davis SR, Pinkerton JV, Lumsden MA, Santen RJ. Approach to the Patient With New-Onset Secondary Amenorrhea: Is This Primary Ovarian Insufficiency? J Clin Endocrinol Metab 2022; 107:825-835. [PMID: 34693971 DOI: 10.1210/clinem/dgab766] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Indexed: 11/19/2022]
Abstract
Menstrual cyclicity is a marker of health for reproductively mature women. Absent menses, or amenorrhea, is often the initial sign of pregnancy-an indication that the system is functioning appropriately and capable of generating the intended evolutionary outcome. Perturbations of menstrual regularity in the absence of pregnancy provide a marker for physiological or pathological disruption of this well-orchestrated process. New-onset amenorrhea with duration of 3 to 6 months should be promptly evaluated. Secondary amenorrhea can reflect structural or functional disturbances occurring from higher centers in the hypothalamus to the pituitary, the ovary, and finally, the uterus. Amenorrhea can also be a manifestation of systemic disorders resulting in compensatory inhibition of reproduction. Identifying the point of the breakdown is essential to restoring reproductive homeostasis to maintain future fertility and reestablish reproductive hormonal integrity. Among the most challenging disorders contributing to secondary amenorrhea is primary ovarian insufficiency (POI). This diagnosis stems from a number of possible etiologies, including autoimmune, genetic, metabolic, toxic, iatrogenic, and idiopathic, each with associated conditions and attendant medical concerns. The dual assaults of unanticipated compromised fertility concurrently with depletion of the normal reproductive hormonal milieu yield multiple management challenges. Fertility restoration is an area of active research, while optimal management of estrogen deficiency symptoms and the anticipated preventive benefits of hormone replacement for bone, cardiovascular, and neurocognitive health remain understudied. The state of the evidence for an optimal, individualized, clinical management approach to women with POI is discussed along with priorities for additional research in this population.
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Affiliation(s)
- Cynthia A Stuenkel
- Department of Medicine, University of California, San Diego, School of Medicine, La Jolla, CA 92093, USA
| | - Anne Gompel
- Unite de Gynecologie Medicale, l'Universite de Paris Descartes, 75015 Paris, France
| | - Susan R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, 3004 Melbourne, Australia
| | - JoAnn V Pinkerton
- Division Director of Midlife Health, University of Virginia Health System, Charlottesville, VA 22908, USA
| | - Mary Ann Lumsden
- University of Glasgow School of Medicine, CEO, International Federation of Obstetrics and Gynecology, Glasgow G31 2ER, UK
| | - Richard J Santen
- Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA
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8
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Cloke B, Rymer J. Premature ovarian insufficiency - the need for a genomic map. Climacteric 2021; 24:444-452. [PMID: 34308731 DOI: 10.1080/13697137.2021.1945025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Premature ovarian insufficiency (POI) is a life-long disorder of heterogeneous etiology, presenting as adolescent primary amenorrhea in its most severe form, with an overall incidence of 1%. Idiopathic POI accounts for up to 70% of women with POI; and genomic, genetic, epidemiological, familial and cohort studies demonstrate a genetic component to this condition. Currently, the only genetic tests routinely performed in non-syndromic POI are FMR1 premutation and cytogenetics, the latter specifically for X-chromosome abnormalities. However, a myriad of genetic aberrations has been identified and implicated, some of which act in a monogenic Mendelian fashion. The presence of multiple genetic aberrations and the complexity of POI genomics are hardly surprising since the embryological formation of the primordial oocyte pool, postnatal oogenesis and folliculogenesis are all highly complex pathways. With this review, the aim is to discuss the current genetic etiologies in the emerging field of POI genomics. Promising candidate genes include STAG3, SYCE1, FIGLA, NOBOX, FSHR, BMP15 and INHA. This area has the potential to progress rapidly in light of advances in genomic technologies. The development of a POI genomic map not only will assist in understanding the underlying molecular mechanisms affecting ovarian function but will also be essential in designing predictive and diagnostic gene panels as well as future novel therapeutic strategies.
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Affiliation(s)
- B Cloke
- Menopause Research Unit, McNair Gynaecology Centre, Guy's Hospital, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - J Rymer
- Menopause Research Unit, McNair Gynaecology Centre, Guy's Hospital, Guy's and St Thomas' Hospitals NHS Trust, London, UK.,School of Medical Education, Faculty of Life Sciences and Medicine, King's College London, London, UK
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9
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Giri R, Vincent AJ. Prevalence and Risk Factors of Premature Ovarian Insufficiency/Early Menopause. Semin Reprod Med 2021; 38:237-246. [PMID: 33434933 DOI: 10.1055/s-0040-1722317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Premature ovarian insufficiency (POI) and early menopause, defined as loss of ovarian activity prior to 40 years or menopause between the ages of 40 and 45 years, respectively, is associated with significant adverse health impacts. Recent data indicate that the prevalence of POI and early menopause is greater than was previously thought, affecting more than 10% of women. Biopsychosocial risk factors including genetic, autoimmune, reproductive, lifestyle, early-life, social/environmental, and iatrogenic have been associated with POI/early menopause or earlier age at menopause. However, establishing a causal role and the underlying mechanisms remains elusive. Understanding and clarification of these risk factors will facilitate prevention and risk minimization strategies to optimize women's health.
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Affiliation(s)
- Rinky Giri
- Department of Endocrinology, Monash Health, Clayton, Victoria, Australia
| | - Amanda J Vincent
- Department of Endocrinology, Monash Health, Clayton, Victoria, Australia.,Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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10
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Premature ovarian insufficiency: clinical orientations for genetic testing and genetic counseling. Porto Biomed J 2020; 5:e62. [PMID: 33299945 PMCID: PMC7722400 DOI: 10.1097/j.pbj.0000000000000062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 03/29/2020] [Indexed: 02/07/2023] Open
Abstract
Premature ovarian insufficiency (POI) is a heterogeneous disorder diagnosed in women before 40 years old and describes a wide range of impaired ovarian function, from diminished ovarian reserve to premature ovarian failure. Genetic etiology accounts for 20% to 25% of patients. The evidence that POI can be isolated (nonsyndromic) or part of a pleiotropic genetic syndrome highlights its high heterogeneous etiology. Chromosomal abnormalities as a cause of POI have a prevalence of 10% to 13%, being 45,X complement the most common cytogenetic cause of primary amenorrhea and mosaicism with a 45,X cell line more frequently associated with secondary amenorrhea. Other X chromosome aberrations include deletions, duplications, balanced, and unbalanced X-autosome rearrangements involving the critical region for the POI phenotype (Xq13-Xq21 to Xq23-Xq27). The identification of 2 or more pathogenic variants in distinct genes argues in favor of a polygenic origin for POI. Hundreds of pathogenic variants (including mitochondrial) have been involved in POI etiology mainly with key roles in biological processes in the ovary, such as meiosis and DNA damage repair mechanism, homologous recombination, follicular development, granulosa cell differentiation and proliferation, and ovulation. The most common single gene cause for POI is the premutation for FMR1 gene (associated with fragile X syndrome) with alleles ranging from about 55 to about 200 CGG trinucleotide repeats. POI occurs in 20% of women with this premutation. As females with premutation or full mutation alleles are also at risk of having affected children, their genetic counseling should include the indication for prenatal diagnosis or preimplantation genetic testing after intracytoplasmic sperm injection and trophectoderm biopsy. In conclusion, in clinical practice high-resolution karyotype and FMR1 gene molecular study should be performed as first-tier tests in the assessment of POI. In addition, array Comparative Genomic Hybridization or specific next generation sequencing panels should be considered to identify chromosomal deletions/duplications under karyotype resolution or other pathogenic variants in specific genes associated with POI. This is particularly important in patients with first- or second-degree relatives also affected with POI, improving their reproductive and genetic counseling.
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11
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Laisk T, Tšuiko O, Jatsenko T, Hõrak P, Otala M, Lahdenperä M, Lummaa V, Tuuri T, Salumets A, Tapanainen JS. Demographic and evolutionary trends in ovarian function and aging. Hum Reprod Update 2020; 25:34-50. [PMID: 30346539 DOI: 10.1093/humupd/dmy031] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 09/03/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The human female reproductive lifespan is regulated by the dynamics of ovarian function, which in turn is influenced by several factors: from the basic molecular biological mechanisms governing folliculogenesis, to environmental and lifestyle factors affecting the ovarian reserve between conception and menopause. From a broader point of view, global and regional demographic trends play an additional important role in shaping the female reproductive lifespan, and finally, influences on an evolutionary scale have led to the reproductive senescence that precedes somatic senescence in humans. OBJECTIVE AND RATIONALE The narrative review covers reproductive medicine, by integrating the molecular mechanisms of ovarian function and aging with short-term demographic and long-term evolutionary trends. SEARCH METHODS PubMed and Google Scholar searches were performed with relevant keywords (menopause, folliculogenesis, reproductive aging, reproductive lifespan and life history theory). The reviewed articles and their references were restricted to those written in English. OUTCOMES We discuss and summarize the rapidly accumulating information from large-scale population-based and single-reproductive-cell genomic studies, their constraints and advantages in the context of female reproductive aging as well as their possible evolutionary significance on the life history trajectory from foetal-stage folliculogenesis until cessation of ovarian function in menopause. The relevant environmental and lifestyle factors and demographic trends are also discussed in the framework of predominant evolutionary hypotheses explaining the origin and maintenance of menopause. WIDER IMPLICATIONS The high speed at which new data are generated has so far raised more questions than it has provided solid answers and has been paralleled by a lack of satisfactory interpretations of the findings in the context of human life history theory. Therefore, the recent flood of data could offer an unprecedented tool for future research to possibly confirm or rewrite human evolutionary reproductive history, at the same time providing novel grounds for patient counselling and family planning strategies.
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Affiliation(s)
- Triin Laisk
- Competence Centre on Health Technologies, Tiigi 61b, Tartu, Estonia.,Institute of Clinical Medicine, Department of Obstetrics and Gynaecology, University of Tartu, L. Puusepa 8, Tartu, Estonia
| | - Olga Tšuiko
- Competence Centre on Health Technologies, Tiigi 61b, Tartu, Estonia.,Institute of Biomedicine and Translational Medicine, Department of Biomedicine, University of Tartu, Ravila 19, Tartu, Estonia
| | - Tatjana Jatsenko
- Competence Centre on Health Technologies, Tiigi 61b, Tartu, Estonia
| | - Peeter Hõrak
- Department of Zoology, University of Tartu, Vanemuise 46, Tartu, Estonia
| | - Marjut Otala
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, Helsinki, Finland
| | - Mirkka Lahdenperä
- Department of Biology, University of Turku, Turun yliopisto, Turku, Finland
| | - Virpi Lummaa
- Department of Biology, University of Turku, Turun yliopisto, Turku, Finland
| | - Timo Tuuri
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, Helsinki, Finland
| | - Andres Salumets
- Competence Centre on Health Technologies, Tiigi 61b, Tartu, Estonia.,Institute of Clinical Medicine, Department of Obstetrics and Gynaecology, University of Tartu, L. Puusepa 8, Tartu, Estonia.,Institute of Biomedicine and Translational Medicine, Department of Biomedicine, University of Tartu, Ravila 19, Tartu, Estonia.,Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, Helsinki, Finland
| | - Juha S Tapanainen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 2, Helsinki, Finland.,Department of Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Medical Research Center Oulu and PEDEGO Research Unit, OYS Oulu, Finland
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12
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Mishra GD, Chung HF, Cano A, Chedraui P, Goulis DG, Lopes P, Mueck A, Rees M, Senturk LM, Simoncini T, Stevenson JC, Stute P, Tuomikoski P, Lambrinoudaki I. EMAS position statement: Predictors of premature and early natural menopause. Maturitas 2019; 123:82-88. [DOI: 10.1016/j.maturitas.2019.03.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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13
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Belli M, Shimasaki S. Molecular Aspects and Clinical Relevance of GDF9 and BMP15 in Ovarian Function. VITAMINS AND HORMONES 2018; 107:317-348. [PMID: 29544636 DOI: 10.1016/bs.vh.2017.12.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Growth and differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) are oocyte-secreted factors with a leading role in the control of ovarian function in female reproduction, modulating both the cell fate of the somatic granulosa cells and the quality and developmental competence of the egg. This short review aims to consolidate the molecular aspects of GDF9 and BMP15 and their integral actions in female fertility to understand particularly their effects on oocyte quality and fetal growth. The significant consequences of mutations in the GDF9 and BMP15 genes in women with dizygotic twins as well as the clinical relevance of these oocyte factors in the pathogenesis of primary ovarian insufficiency and polycystic ovary syndrome are also addressed.
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Affiliation(s)
- Martina Belli
- University of California San Diego, School of Medicine, La Jolla, CA, United States
| | - Shunichi Shimasaki
- University of California San Diego, School of Medicine, La Jolla, CA, United States.
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14
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Elfayomy AK, Almasry SM, El-Tarhouny SA, Eldomiaty MA. Human umbilical cord blood-mesenchymal stem cells transplantation renovates the ovarian surface epithelium in a rat model of premature ovarian failure: Possible direct and indirect effects. Tissue Cell 2016; 48:370-82. [PMID: 27233913 DOI: 10.1016/j.tice.2016.05.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/04/2016] [Accepted: 05/07/2016] [Indexed: 01/09/2023]
Abstract
This study aimed to isolate mesenchymal stem cells (MSC) from human umbilical cord blood (HCB) and to explore their influence on the ovarian epithelium after paclitaxel-induced ovarian failure. Ninety-five rats were divided into 6 groups: control, paclitaxel, paclitaxel and saline, HCB-MSC-treated for 2 weeks, HCB-MSC-treated for 4 weeks, and HCB-MSC-treated for 6 weeks. HCB cells were studied for CD34, CD44, and Oct ¾ using flow cytometry. Serum levels of FSH and E2 were measured using ELISA, RT-PCR analysis for human gene; beta-actin (ACTB), immunohistochemical analysis for CK 8/18, TGF-ß, PCNA and CASP-3 were performed. We found that ACTB gene was expressed in all rats' ovaries received HCB-MSC. After 4 weeks of transplantation, there was significant reduction in FSH, elevation in E2 levels, stabilization of the surface epithelium morphostasis, an increase in the antral follicle count and increase in integrated densities (ID) of CK 8/18, TGF-ß, and PCNA expressions and decrease in ID of CASP-3 expression. We concluded that HCB-MSC can restore the ovarian function after paclitaxel injection through a direct triggering effect on the ovarian epithelium and/or indirect enrichment of ovarian niche through regulating tissue expression of CK 8/18, TGF-ß and PCNA. These molecules are crucial in regulating folliculogenesis and suppressing CASP-3-induced apoptosis.
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Affiliation(s)
- Amr K Elfayomy
- Department of Obstetrics and Gynecology, Taibah University, Almadinah Almunawarah, Saudi Arabia; Department of Obstetrics and Gynecology, Zagazig University, Zagazig, Egypt
| | - Shaima M Almasry
- Department of Anatomy, Taibah University, Almadinah Almunawarah, Saudi Arabia; Department of Anatomy, Mansoura University, Mansoura, Egypt.
| | - Shereen A El-Tarhouny
- Department of Clinical Biochemistry, Taibah University, Saudi Arabia; Department of Medical Biochemistry, Zagazig University, Egypt
| | - Magda A Eldomiaty
- Department of Anatomy, Taibah University, Almadinah Almunawarah, Saudi Arabia; Department of Anatomy, Tanta University, Tanta, Egypt
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15
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Events in Early Life are Associated with Female Reproductive Ageing: A UK Biobank Study. Sci Rep 2016; 6:24710. [PMID: 27094806 PMCID: PMC4837365 DOI: 10.1038/srep24710] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 04/04/2016] [Indexed: 12/14/2022] Open
Abstract
The available oocyte pool is determined before birth, with the majority of oocytes lost before puberty. We hypothesised that events occurring before birth, in childhood or in adolescence (‘early-life risk factors’) could influence the size of the oocyte pool and thus the timing of menopause. We included cross-sectional data from 273,474 women from the UK Biobank, recruited in 2006–2010 from across the UK. We analysed the association of early menopause with events occurring before adulthood in 11,781 cases (menopause aged under 45) and 173,641 controls (menopause/pre-menopausal at ≥45 years), in models controlling for potential confounding variables. Being part of a multiple birth was strongly associated with early menopause (odds ratio = 1.42, confidence interval: 1.11, 1.82, P = 8.0 × 10−9, fully-adjusted model). Earlier age at menarche (odds ratio = 1.03, confidence interval: 1.01, 1.06, P = 2.5 × 10−6) and earlier year of birth were also associated with EM (odds ratio = 1.02, confidence interval: 1.00, 1.04, P = 8.0 × 10−6). We also confirmed previously reported associations with smoking, drinking alcohol, educational level and number of births. We identified an association between multiple births and early menopause, which connects events pre-birth, when the oocyte pool is formed, with reproductive ageing in later life.
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16
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Yldrm G, Tokmak A, Kokanal MK, Sarkaya E, Züngün C, İnal HA, Ylmaz FM, Ylmaz N. Association between some inflammatory markers and primary ovarian insufficiency. Menopause 2016; 22:1000-5. [PMID: 25647778 DOI: 10.1097/gme.0000000000000423] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study investigated the discriminative values of neutrophil-to-lymphocyte ratio (NLR), serum amyloid A protein (SAA), and C-reactive protein (CRP) in cases of primary ovarian insufficiency (POI). METHODS A total of 84 women were included in this comparative cross-sectional study. The study group consisted of 43 women diagnosed as having POI, and the control group consisted of 41 women with normal fertility. After obtaining a written informed consent form from all participants, we retrieved clinical and demographic data and laboratory findings from the participants and the hospital database. The following variables were analyzed: age, body mass index, smoking, family history, comorbidities, sonographic findings, complete blood count, baseline hormone levels, CRP, and SAA. RESULTS NLR was significantly lower in the study group than in the control group (mean [SD], 1.3 [0.7] vs 2.0 [0.7]; P < 0.001). The mean SAA level was 151.6 ng/mL (range, 48.5-12,554.7 ng/mL) in the study group and 147.8 ng/mL (range, 29.8-3,760.4 ng/mL) in the control group (P > 0.05). There was no significant difference in serum CRP levels between two groups (P > 0.05). Receiver operating characteristic analysis revealed that NLR, but not SAA and CRP, was a significantly discriminative parameter for POI (area under the curve, 0.829; P < 0.001). Multivariate logistic regression analysis showed that a family history of POI, smoking, and NLR of 1.5 or less were independent risk factors for POI. CONCLUSIONS SAA and CRP do not seem to be valuable discriminative markers for POI, whereas NLR may be a significant promising marker before presentation or in the early stages of POI and may be useful for developing appropriate fertility treatment options.
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Affiliation(s)
- Gülçin Yldrm
- 1Department of Obstetrics and Gynecology, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital, Ankara, Turkey 2Department of Biochemistry, Ankara Numune Training and Research Hospital, Ankara, Turkey
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17
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Hou N, Chen S, Chen F, Jiang M, Zhang J, Yang Y, Zhu B, Bai X, Hu Y, Huang H, Xu C. Association between premature ovarian failure, polymorphisms in MTHFR and MTRR genes and serum homocysteine concentration. Reprod Biomed Online 2016; 32:407-13. [PMID: 26874989 DOI: 10.1016/j.rbmo.2016.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 12/16/2022]
Abstract
This study investigated the association between premature ovarian failure (POF), MTHFR C677T/A1298C and MTRR A66G genotypes and serum homocysteine (Hcy) concentration. A prospective study was conducted in Chinese women, which included POF patients (n = 180) and controls (n = 195). Peripheral blood samples were used to determine MTHFR C677T/A1298C and MTRR A66G genotypes, and serum Hcy and sex hormone concentrations. Results showed that serum Hcy concentrations of POF patients were significantly higher than those of controls (P < 0.0001). In POF patients, serum Hcy concentrations were significantly correlated with oestradiol and FSH concentrations (r = -0.174, P = 0.037 and r = +0.238, P = 0.006, respectively). There were no significant differences in the distributions of MTHFR C677T/A1298C or MTRR A66G genotypes between the two groups. However, these genetic variants influenced serum Hcy concentrations in POF patients, especially for MTRR 66 AA/AG/GG genotypes, which were significantly correlated with the patients' Hcy concentrations (τ = 0.166, P = 0.033). These results suggest that serum Hcy concentrations in Chinese POF patients are increased and correlated with serum oestradiol/FSH concentrations. In conclusion, MTHFR C667T/A1298C and MTRR A66G genotypes are not associated with POF development, but they affect the patients' serum Hcy concentrations.
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Affiliation(s)
- Ningning Hou
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Songchang Chen
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Feng Chen
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Minmin Jiang
- Institute of Public Administration, Zhejiang Normal University, Hangzhou 310012, China
| | - Junyu Zhang
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yanmei Yang
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Bo Zhu
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Xiaoxia Bai
- Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yuting Hu
- International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Hefeng Huang
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
| | - Chenming Xu
- Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University), Hangzhou 310006, China; International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
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18
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Cell therapy for chemically induced ovarian failure in mice. Stem Cells Int 2014; 2014:720753. [PMID: 25548574 PMCID: PMC4274854 DOI: 10.1155/2014/720753] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 10/15/2014] [Accepted: 10/16/2014] [Indexed: 12/21/2022] Open
Abstract
Cell therapy has been linked to an unexplained return of ovarian function and fertility in some cancer survivors. Studies modeling this in mice have shown that cells transplantation generates donor-derived oocytes in chemotherapy-treated recipients. This study was conducted to further clarify the impact of cell transplantation from different sources on female reproductive function after chemotherapy using a preclinical mouse model. Methods. Female mice were administered 7.5 mg/kg cisplatin followed by cell transplantation (one week later) using GFP+ female cell donors. For cell tracking, adipose derived stem cell GFP+ (ADSC), female germline stem cell GFP+/MVH+ (FGSC), or ovary cell suspension GFP+ mice were transplanted into cisplatin-treated wild-type recipients. After 7 or 14 days animals were killed and histological analysis, IHQ for GFP cells, and ELISA for estradiol were performed. Results. Histological examinations showed that ADSC, ovary cell suspension, and FGSC transplant increase the number of follicles with apparent normal structure in the cells recipient group euthanized on day 7. Cell tracking showed GFP+ samples 7 days after transplant. Conclusion. These data suggest that intraovarian injection of ADSCs and FGSC into mice with chemotherapy-induced ovarian failure diminished the damage caused by cisplatin.
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19
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Chen CTL, Liu CT, Chen GK, Andrews JS, Arnold AM, Dreyfus J, Franceschini N, Garcia ME, Kerr KF, Li G, Lohman KK, Musani SK, Nalls MA, Raffel LJ, Smith J, Ambrosone CB, Bandera EV, Bernstein L, Britton A, Brzyski RG, Cappola A, Carlson CS, Couper D, Deming SL, Goodarzi MO, Heiss G, John EM, Lu X, Le Marchand L, Marciante K, Mcknight B, Millikan R, Nock NL, Olshan AF, Press MF, Vaiyda D, Woods NF, Taylor HA, Zhao W, Zheng W, Evans MK, Harris TB, Henderson BE, Kardia SLR, Kooperberg C, Liu Y, Mosley TH, Psaty B, Wellons M, Windham BG, Zonderman AB, Cupples LA, Demerath EW, Haiman C, Murabito JM, Rajkovic A. Meta-analysis of loci associated with age at natural menopause in African-American women. Hum Mol Genet 2014; 23:3327-42. [PMID: 24493794 PMCID: PMC4030781 DOI: 10.1093/hmg/ddu041] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 01/11/2014] [Accepted: 01/27/2014] [Indexed: 12/23/2022] Open
Abstract
Age at menopause marks the end of a woman's reproductive life and its timing associates with risks for cancer, cardiovascular and bone disorders. GWAS and candidate gene studies conducted in women of European ancestry have identified 27 loci associated with age at menopause. The relevance of these loci to women of African ancestry has not been previously studied. We therefore sought to uncover additional menopause loci and investigate the relevance of European menopause loci by performing a GWAS meta-analysis in 6510 women with African ancestry derived from 11 studies across the USA. We did not identify any additional loci significantly associated with age at menopause in African Americans. We replicated the associations between six loci and age at menopause (P-value < 0.05): AMHR2, RHBLD2, PRIM1, HK3/UMC1, BRSK1/TMEM150B and MCM8. In addition, associations of 14 loci are directionally consistent with previous reports. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in women of African ancestry residing in USA.
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Affiliation(s)
- Christina T L Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Ching-Ti Liu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA
| | | | - Jeanette S Andrews
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | | | - Jill Dreyfus
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD 20814, USA
| | | | - Guo Li
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | - Kurt K Lohman
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Solomon K Musani
- University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Michael A Nalls
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Jennifer Smith
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Elisa V Bandera
- The Cancer Institute of New Jersey, New Brunswick, NJ 08903, USA
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Science, Beckman Research Institute, City of Hope, Duarte, CA 91010, USA
| | - Angela Britton
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD 20892, USA
| | - Robert G Brzyski
- Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio, TX 78229, USA
| | - Anne Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christopher S Carlson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - David Couper
- Department of Biostatistics, Gillings School of Global Public Health
| | - Sandra L Deming
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes, and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health
| | - Esther M John
- Division of Epidemiology, Department of Health Research & Policy, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Xiaoning Lu
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA Division of Clinical Informatics, Beth Israel Deaconess Medical Center, Boston, MA 02118, USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center, University of Hawaii, Honolulu, HI 96813, USA
| | - Kristin Marciante
- Department of Medicine, University of Washington, Seattle, WA 98195, USA
| | | | - Robert Millikan
- Department of Epidemiology, Gillings School of Global Public Health Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Nora L Nock
- Department of Epidemiology and Biostatistics, Case Western University, Cleveland, OH 44106, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Michael F Press
- Department of Pathology, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
| | - Dhananjay Vaiyda
- Department of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Nancy F Woods
- Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA 98109, USA
| | - Herman A Taylor
- University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Wei Zhao
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Michele K Evans
- Health Disparities Research Section, Clinical Research Branch
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD 20814, USA
| | | | - Sharon L R Kardia
- Department of Epidemiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Thomas H Mosley
- Division of Geriatric Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Bruce Psaty
- Departments of Medicine, Epidemiology and Health Services, University of Washington and Group Health Research Institute, Seattle, WA, USA
| | - Melissa Wellons
- School of Medicine, Vanderbilt University, Nashville, TN 37240, USA
| | - Beverly G Windham
- Division of Geriatric Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Alan B Zonderman
- Laboratory of Personality and Cognition, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - L Adrienne Cupples
- Department of Biostatistics, School of Public Health, Boston University, Boston, MA 02118, USA National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA
| | - Ellen W Demerath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Joanne M Murabito
- National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA 01702, USA Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Aleksandar Rajkovic
- Department of Obstetrics, Gynecology and Reproductive Science, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Abd-Allah SH, Shalaby SM, Pasha HF, El-Shal AS, Raafat N, Shabrawy SM, Awad HA, Amer MG, Gharib MA, El Gendy EA, Raslan AA, El-Kelawy HM. Mechanistic action of mesenchymal stem cell injection in the treatment of chemically induced ovarian failure in rabbits. Cytotherapy 2013; 15:64-75. [PMID: 23260087 DOI: 10.1016/j.jcyt.2012.08.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/16/2012] [Indexed: 01/02/2023]
Abstract
BACKGROUND No curative treatment is known for primary ovarian failure; however, mesenchymal stem cells (MSCs), through self-renewal and regeneration, push the trial to evaluate their role in the treatment of ovarian failure. The aim of this study was to explore the impact of MSCs on cyclophosphamide (CTX)-induced ovarian failure in rabbits and to clarify the mechanism(s) by which MSCs exert their action. METHODS Thirty-five adult female rabbits were injected with CTX to induce ovarian failure. Five rabbits were euthanized after the last injection of CTX for histological examination. The others (30 rabbits) were further subdivided into two groups: group 1 (ovarian failure group, 15 rabbits) received no treatment; group 2 (ovarian failure and MSC recipient group, 15 rabbits) received MSCs isolated from extracted bone marrow of male rabbits. RESULTS A decrease of follicle-stimulating hormone and an increase of estrogen and vascular endothelial growth factor (VEGF) levels in the MSC recipient group versus the ovarian failure group were found. Weak caspase-3 expression and +ve proliferating cell nuclear antigen staining after MSC injection were detected. Cytological and histological examinations showed increased follicle numbers with apparent normal structure of ovarian follicles in the MSC recipient group. Moreover, Y chromosome-containing cells from male donors were present within the ovarian tissues in group 2. CONCLUSIONS The current study suggests that intravenous injection of MSCs into rabbits with chemotherapy-induced ovarian damage improved ovarian function. MSCs accomplish this function by direct differentiation into specific cellular phenotypes and by secretion of VEGF, which influence the regeneration of the ovary.
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Affiliation(s)
- Somia H Abd-Allah
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
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Scientific molecular basis for treatment of reproductive failure in the human: An insight into the future. Biochim Biophys Acta Mol Basis Dis 2012; 1822:1981-96. [DOI: 10.1016/j.bbadis.2012.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 10/01/2012] [Accepted: 10/02/2012] [Indexed: 01/15/2023]
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Ferrarini E, Russo L, Fruzzetti F, Agretti P, De Marco G, Dimida A, Gianetti E, Simoncini T, Simi P, Baldinotti F, Benelli E, Pucci E, Pinchera A, Vitti P, Tonacchera M. Clinical characteristics and genetic analysis in women with premature ovarian insufficiency. Maturitas 2012; 74:61-7. [PMID: 23107817 DOI: 10.1016/j.maturitas.2012.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 09/28/2012] [Accepted: 09/29/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Premature ovarian insufficiency (POI) is defined as a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 (secondary amenorrhea) with hypergonadotropism and hypoestrogenism. METHODS We studied the clinical, biological, and genetic data related to 50 POI patients with a mean age of menopause of 29 years (94% with secondary amenorrhea, 6% with primary amenorrhea and 15% with a family history of POI). Seventeen patients were affected by endocrine autoimmune diseases, antral follicles were observed in 31 patients by ultrasonography. RESULTS Karyotype analysis did not show any abnormality of the X chromosome. No mutation in FSH receptor and GDF-9 genes was reported, while in one patient a variant of BMP-15 gene (A180T) was found. Four patients had fragile X mental retardation 1 gene (FMR1) premutation and one an intermediate sized CGG repeats of the same gene. Two patients with FMR1 premutation were sister and developed secondary amenorrhea at the age of 34 and 37 years. The other two patients presented with oligoamenorrhea at the age of 39 and 34 years. The patient harboured the intermediate sized CGG repeats developed secondary amenorrhea at the age of 33 years. CONCLUSIONS The genetic analysis performed on a cohort of patients with POI revealed that 8% had FMR1 premutation and only one patient a previously known variant of BMP-15 gene. No alteration of the karyotype and FSH receptor and GDF-9 genes was evidenced.
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Affiliation(s)
- Eleonora Ferrarini
- Department of Endocrinology, Research Center of Excellence AmbiSEN, University of Pisa, Pisa, Italy
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Genetic markers of ovarian follicle number and menopause in women of multiple ethnicities. Hum Genet 2012; 131:1709-24. [PMID: 22696150 PMCID: PMC3470691 DOI: 10.1007/s00439-012-1184-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 05/23/2012] [Indexed: 01/22/2023]
Abstract
Oocyte loss has a significant impact on fertility and somatic health. Yet, we know little about factors that impact this process. We sought to identify genetic variants associated with ovarian reserve (oocyte number as measured by antral follicle count, AFC). Based on recently published genome-wide scans that identified loci associated with age of menopause, we also sought to test our hypothesis that follicle number and menopausal age share underlying genetic associations. We analyzed menopause-related variants for association with follicle number in an independent population of approximately 450 reproductive-aged women of European and African ancestry; these women were assessed for AFC, anthropometric, clinical, and lifestyle factors. One SNP strongly associated with later menopausal age in Caucasian women (+1.07 ± 0.11 years) in previous work was also associated with higher follicle counts in Caucasians (+2.79 ± 1.67 follicles) in our study. This variant is within the Minichromosome Maintenance Complex Component 8 (MCM8) gene, which we found was expressed within oocytes in follicles of the human ovary. In genome-wide scans of AFC, we also identified one marginally genome-wide and several nominally significant SNPs within several other genes associated with follicle number in both ethnic groups. Further, there were overlapping variants associated with multiple ovarian reserve markers (AFC, serum hormone levels, menopausal age). This study provides the first evidence for direct genetic associations underlying both follicle number and menopause and identifies novel candidate genes. Genetic variants associated with ovarian reserve may facilitate discovery of genetic markers to predict reproductive health and lifespan in women.
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Chen CTL, Fernández-Rhodes L, Brzyski RG, Carlson CS, Chen Z, Heiss G, North KE, Woods NF, Rajkovic A, Kooperberg C, Franceschini N. Replication of loci influencing ages at menarche and menopause in Hispanic women: the Women's Health Initiative SHARe Study. Hum Mol Genet 2012; 21:1419-32. [PMID: 22131368 PMCID: PMC3284121 DOI: 10.1093/hmg/ddr570] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/04/2011] [Accepted: 11/28/2011] [Indexed: 12/17/2022] Open
Abstract
Several genome-wide studies have identified loci associated with reproductive traits, such as ages of menarche and menopause, in women of European ancestry. In this study, we investigated the relevance of these loci in minority US Hispanic women. We utilized data from 3468 women who were genotyped as a part of the Women's Health Initiative SNP Health Association Resource. We replicated associations of eight loci (LRP18, LIN28B, CENPW, INHBA, TMEM38B, ZNF483, NFAT5 and OLFM2) with age at menarche, and of two loci (MCM8 and BRSK1/TMEM150B) with age at menopause. The MCM8 locus was also associated with early menopause risk. Three loci (CENPW, MCM8 and BRSK1/TMEM150B) were associated with the length of reproductive lifespan. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in minority US Hispanic women.
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Affiliation(s)
- Christina T L Chen
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Béranger R, Hoffmann P, Christin-Maitre S, Bonneterre V. Occupational exposures to chemicals as a possible etiology in premature ovarian failure: a critical analysis of the literature. Reprod Toxicol 2012; 33:269-79. [PMID: 22281303 DOI: 10.1016/j.reprotox.2012.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 12/15/2011] [Accepted: 01/10/2012] [Indexed: 01/25/2023]
Abstract
Premature ovarian failure (POF) is a cause of infertility that affects about 1% of women under 40, and is considered as idiopathic in 75% of cases. An occupational chemical origin has been identified at least once with 2-bromopropane, but human studies are rare and experimental data are sparse. This review aims to carry out a critical synthesis of knowledge of the chemical agents likely to affect follicular stock in humans and/or animals, by direct toxicity to follicles, or by increasing their recruitments. Of 140 chemical agents (or groups) studied, 20 have been identified as potentially damaging to the ovarian reserve. For the majority of toxic agents, only experimental data are currently available. At least four of these agents are likely to lead to POF in descendents (ethylene glycol methyl ether; 2,2-bis(bromomethyl)-1,3-propanediol; benzo[a]pyrene; dimethylbenzantracene). We propose a strategy aiming to encourage progress in identifying occupational factors responsible for POF.
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Affiliation(s)
- Rémi Béranger
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 (EPSP Team: Environnement et Prédiction de la Santé des Populations), Grenoble F-38041, France.
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Silber SJ. Ovary cryopreservation and transplantation for fertility preservation. Mol Hum Reprod 2011; 18:59-67. [DOI: 10.1093/molehr/gar082] [Citation(s) in RCA: 156] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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MacLean FR, Thomson SA, Gallacher SJ. Using WHO-FRAX to describe fracture risk: experience in primary care. Scott Med J 2011; 57:8-13. [PMID: 22179858 DOI: 10.1258/smj.2011.011185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Ideally those at highest risk of fracture should be identified prior to fracture occurrence to reduce mortality, morbidity and costs. Case-finding strategies for those at high risk of first fracture or systematic case-finding strategies following fracture are recommended in the UK, rather than population-based screening to identify individuals at high fracture risk. General practices in the UK hold relevant data on individuals beyond fracture history that could allow identification of a wider group of patients at highest risk of fracture. The aim of the paper is to evaluate the feasibility of applying the WHO-FRAX fracture risk calculator to general practice populations using existing recorded data. A cross-sectional study of 2467 women aged 50 years and older (mean 66.2 years, standard deviation = 11.3) registered with two Scottish General Practices with low deprivation (one semi-rural, one urban) was undertaken. Patient data were extracted from the two general practices' patient information databases and the WHO-FRAX calculator was applied to these data. WHO-FRAX calculation was possible on 1872 patients. Of these, 687 patients were found to have a high fracture risk (risk of major facture ≥15% and or risk of hip fracture ≥3% - 37% of the WHO-FRAX assessed cohort) and should be considered for follow-up. In conclusion, use of the WHO-FRAX calculator using general practice-held data is feasible and can help to identify a patient group at higher fracture risk. Further evaluation and treatments can then be targeted at this group.
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Affiliation(s)
- F R MacLean
- Levenside Medical Practice, Station Road, Dumbarton G82 1PW, Scotland, UK.
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Singer D, Mann E, Hunter MS, Pitkin J, Panay N. The silent grief: psychosocial aspects of premature ovarian failure. Climacteric 2011; 14:428-37. [DOI: 10.3109/13697137.2011.571320] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Thomson TC, Fitzpatrick KE, Johnson J. Intrinsic and extrinsic mechanisms of oocyte loss. Mol Hum Reprod 2010; 16:916-27. [PMID: 20651035 DOI: 10.1093/molehr/gaq066] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A great deal of evolutionary conservation has been found in the control of oocyte development, from invertebrates to women. However, little is known of mechanisms that control oocyte loss over time. Oocyte loss is often assumed to be a result of oocyte-intrinsic deficiencies or damage. In fruit flies, starvation results in halted oocyte production by germline stem cells and induces oocyte loss midway through development. When we fed wild-type flies the bacterial compound Rapamycin (RAP) to mimic starvation, production of new oocytes continued, but mid-stage loss sterilized the animals. Surprisingly, follicle cell invasion and phagocytosis of the oocyte preceded any signs of germ cell death. RAP-induced egg chamber loss was prevented when RAP receptor FKBP12 was knocked down specifically in follicle cells. Oogenesis continued past the mid-stages, and these mutants continued to lay embryos that could develop into normal adults. Hence, intact healthy oocytes can be destroyed by somatic cells responding to extrinsic stimuli. We termed this process inducible somatic oocyte destruction. RAP treatment of mouse follicles in vitro resulted in phagocytic uptake of the oocyte by granulosa cells as seen in flies. We hypothesize that extrinsic modes of oocyte loss occur in mammals.
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Affiliation(s)
- Travis C Thomson
- Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Reproductive Endocrinology and Infertility, Yale School of Medicine, 333 Cedar Street FMB 329F, New Haven, CT 06520, USA
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Coxworth JE, Hawkes K. Ovarian follicle loss in humans and mice: lessons from statistical model comparison. Hum Reprod 2010; 25:1796-805. [DOI: 10.1093/humrep/deq136] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fiçicioglu C, Yildirim G, Attar R, Kumbak B, Yesildaglar N. The significance of the number of CGG repeats and autoantibodies in premature ovarian failure. Reprod Biomed Online 2010; 20:776-82. [PMID: 20362512 DOI: 10.1016/j.rbmo.2010.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 10/01/2009] [Accepted: 01/19/2010] [Indexed: 11/28/2022]
Abstract
The objective of this study was to determine whether there was a threshold for the number of CGG repeats in the FMR1 (fragile X) gene in premature ovarian ageing and premature ovarian failure and to investigate the association of this sequence with serum concentrations of anti-Müllerian hormone (AMH), inhibin B, anti-thyroid and anti-adrenal autoantibodies. In this prospective randomized controlled preliminary study, the number of triple CGG repeats and serum concentrations of FSH, AMH and aforementioned autoantibodies were evaluated in 79 women who were younger than 40 years old. FSH concentrations were between 12 and 50 IU/ml (premature ovarian ageing) in 30 women and were higher than 50 IU/ml (premature ovarian failure) in nine women; FSH concentrations were normal in 40 women. All women whose FSH concentrations were higher than 12 IU/ml had CGG repeats greater than 30. No women whose FSH concentrations were normal had a repeat number above 30. There was no significant relationship between the levels of antibodies and either CGG repeat numbers or FSH concentrations. In conclusion, the number of CGG repeats between 30 and 40 might be used to predict premature ovarian ageing and premature ovarian failure in infertile women.
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Affiliation(s)
- Cem Fiçicioglu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Yeditepe University Hospital, Devlet Yolu, Ankara Cad. No. 102-104, 34752 Kozyatagi, Istanbul, Turkey.
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Lambalk CB, van Disseldorp J, de Koning CH, Broekmans FJ. Testing ovarian reserve to predict age at menopause. Maturitas 2009; 63:280-91. [PMID: 19631481 DOI: 10.1016/j.maturitas.2009.06.007] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 06/18/2009] [Accepted: 06/22/2009] [Indexed: 11/28/2022]
Abstract
In modern society with women delaying pregnancy, predicting the age of the natural menopause with its preceding infertility will allow making informed choices about when to try starting to have children. Also if premature menopause could be predicted in young women, strategies could be instigated to reduce the long term health risks of early estrogen deficiency. This review examines the physiology of ovarian ageing, with the menopause being the final outcome. Long and short term predictive markers of the age of the menopause and the preceding natural infertility are evaluated. Many subtle changes in the endocrine regulation of ovarian function with advancing age may seem interesting but currently are not clinically useful as a predictive test. Examples are changes in concentrations of estradiol, progesterone, luteinizing hormone (LH) and activin, as well as follicle dynamics. Other features hold more promise. Among these are chronological age, family history, anti-Müllerian hormone (AMH), poor response to in vitro fertilization (IVF), basal follicle-stimulating hormone (FSH) and the antral follicle count for long term prediction. For short term prediction, cycle shortening and occurrence of vasomotor symptoms may prove useful. To date, none of these markers has been found to have sufficient predictive accuracy in individual women. Results of new and ongoing longitudinal studies may provide better predictive models. In particular, use of genetic profiles may add to the accuracy of currently known markers.
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Affiliation(s)
- C B Lambalk
- Division of Reproductive Medicine, Department of Obstetrics/Gynaecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
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Gallicchio L, Miller S, Greene T, Zacur H, Flaws JA. Premature ovarian failure among hairdressers. Hum Reprod 2009; 24:2636-41. [DOI: 10.1093/humrep/dep252] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Gleicher N, Weghofer A, Oktay K, Barad D. Do etiologies of premature ovarian aging (POA) mimic those of premature ovarian failure (POF)? Hum Reprod 2009; 24:2395-400. [PMID: 19617205 DOI: 10.1093/humrep/dep256] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Norbert Gleicher
- Center for Human Reproduction, 21 East 69th Street, New York, NY 10021, USA.
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Mehta S, Wang T. Intermittent ovarian and thyroid failure and spontaneous twin pregnancy. Ann Clin Biochem 2008; 45:331-4. [DOI: 10.1258/acb.2007.007170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intermittent failure of two endocrine systems is unusual and presents diagnostic and management challenges. We report a case of a young woman with intermittent thyroid and ovarian failure who had spontaneous twin gestation four years after the diagnosis of premature ovarian failure was made. This case demonstrates coincidental biochemical and clinical thyroid and ovarian failure both of which spontaneously resolved with no treatment, although subsequently irreversible hypothyroidism ensued after the initial recovery. Elevated gonadotrophins with a menopausal pattern on more than one occasion, in an amenorrhoeic patient with menopausal symptoms, usually indicates permanent ovarian failure. This case demonstrates that this may not be true and while this is probably a rare occurrence, clinicians need to be aware of this possibility. It also re-emphasizes the need to consider the clinical picture when interpreting biochemical results.
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Affiliation(s)
- Shweta Mehta
- Department of Clinical Biochemistry, The Royal Surrey County Hospital, Guildford GU2 7XX, UK
| | - Tim Wang
- Department of Clinical Biochemistry, The Royal Surrey County Hospital, Guildford GU2 7XX, UK
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Hoekstra C, Zhao ZZ, Lambalk CB, Willemsen G, Martin NG, Boomsma DI, Montgomery GW. Dizygotic twinning. Hum Reprod Update 2007; 14:37-47. [PMID: 18024802 DOI: 10.1093/humupd/dmm036] [Citation(s) in RCA: 124] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The tendency to conceive spontaneous dizygotic (DZ) twins is a complex trait with important contributions from both environmental factors and genetic disposition. Twins are relatively common and occur on average 13 times per 1000 maternities, though the twinning frequency varies over time and geographic location. This variation is mostly attributed to the differences in DZ twinning rate, since the monozygotic twinning rate is relatively constant. DZ twinning is in part under genetic control, with mothers of DZ twins reporting significantly more female family members with DZ twins than mothers of monozygotic twins. Maternal factors such as genetic history, advanced age and increased parity are known to increase the risk of DZ twins. Recent research confirmed that taller mothers and mothers with a high body mass index (30>) are at greater risk of DZ twinning. Seasonality, smoking, oral contraceptive use and folic acid show less convincing associations with twinning. Genetic analysis is beginning to identify genes contributing to the variation in twinning. Mutations in one of these genes (growth differentiation factor 9) are significantly more frequent in mothers of DZ twins. However, the mutations are rare and only account for a small part of the genetic contribution for twinning.
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Affiliation(s)
- Chantal Hoekstra
- Department of Biological Psychology, VU University Amsterdam, van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands.
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Silber SJ, Gosden RG. Ovarian transplantation in a series of monozygotic twins discordant for ovarian failure. N Engl J Med 2007; 356:1382-4. [PMID: 17392316 DOI: 10.1056/nejmc066574] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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