Basic & Clinical Medicine ›› 2023, Vol. 43 ›› Issue (4): 538-546.doi: 10.16352/j.issn.1001-6325.2023.04.0538

• Invited Reviews: Basic Research of Reproduction • Previous Articles     Next Articles

In vitro follicle activation as a strategy for assisted reproduction in patients with premature ovarian insufficiency: research advances

LIU Zhan'ao1, CHEN Chen2*   

  1. 1. The 3rd Clinical Department;
    2. School of Life Sciences, Key Laboratory of Medical Cell Biology, Ministry of Education; Key Laboratory of Cell Biology, National Health Commission, China Medical University, Shenyang 110122, China
  • Received:2022-07-30 Revised:2022-12-30 Online:2023-04-05 Published:2023-04-03
  • Contact: *

Abstract: Premature ovarian insufficiency (POI) refers to ovarian dysfunction in women before the age of 40 years, and its pathological basis is the depletion or difficult activation of primordial follicle. POI patients have a low natural conception rate and poor effect of ovulation induction therapy. At present, there is no effective method to restore ovarian function. In vitro activation (IVA) for follicles refers to surgical removal of part of the ovarian tissue, followed by drug or physical intervention in vitro, to activate the patient's remaining follicles. Finally, the tissue is rafted back to the same ovary so that it can develop to the stage of responding to ovulation induction. In conjunction with the above procedure, ovulation induction can obtain mature follicles for in vitro fertilization and embryo transfer. IVA technology is an innovative therapeutic option for POI, and provides a new direction for the treatment of POI patients. This article summarizes the principle of IVA, related signaling pathways and drug targets in each pathway, and reviews the application and optimization of IVA protocols in POI patients, so as to provide a basis for the diagnosis and treatment of patients with POI.

Key words: in vitro follicular activation, premature ovarian insufficiency, PTEN/PI3K/Akt, mTOR, Hippo

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