国际生殖健康/计划生育 ›› 2020, Vol. 39 ›› Issue (4): 319-323.

• 综述 • 上一篇    下一篇

体外激活治疗早发性卵巢功能不全的作用机制及进展

尹兰兰,汪晨曦,马天仲   

  1. 524001  广东省湛江市,广东医科大学附属医院生殖医学中心
  • 收稿日期:2020-03-20 修回日期:2020-04-19 出版日期:2020-07-15 发布日期:2020-07-15
  • 通讯作者: 马天仲,E-mail:tiann8283@163.com E-mail:tiann8283@163.com
  • 基金资助:
    广东省自然科学基金项目(2018A0303130308);广东省医学科研基金项目(B2019007);湛江市科技发展专项资金竞争性分配项目(2019A01023)

Research Progress in In Vitro Activation Therapy for Premature Ovarian Insufficiency

YIN Lan-lan,WANG Chen-xi,MA Tian-zhong   

  1. Reproductive Medicine Center,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong Province,China
  • Received:2020-03-20 Revised:2020-04-19 Published:2020-07-15 Online:2020-07-15
  • Contact: Reproductive Medicine Center,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong Province,China E-mail:tiann8283@163.com

摘要: 早发性卵巢功能不全(POI)是导致女性卵巢激素缺乏和不孕的重要原因,约1%的育龄女性受到POI的困扰,目前尚无改善POI患者卵巢功能的最佳方案。最近有学者将体外激活(IVA)用于POI患者的不育治疗。部分POI患者卵巢皮质中仍残留着一定数量处于休眠状态的始基卵泡,IVA是通过卵巢皮质的碎裂破坏Hippo信号通路,并用蛋白激酶B(AKT)激活剂培养卵巢皮质片激活磷脂酰肌醇3激酶(PI3K)-AKT信号通路,从而激活休眠的始基卵泡,使其生长发育为可用于辅助生殖技术的卵母细胞。IVA可有效促进卵泡生长,目前已有成功妊娠并分娩的报道。现简述PI3K-AKT和Hippo信号通路对始基卵泡激活的调控作用,并综述IVA治疗POI的现状及研究进展。

关键词: 原发性卵巢功能不全;, 卵巢;, 卵泡;, 胞间信号肽类和蛋白质类;, 信号传导;, 磷酸肌醇3-激酶类;, 蛋白激酶类;, 体外激活

Abstract: Premature ovarian insufficiency (POI) is an essential cause of female ovarian hormone deficiency and infertility. About 1% of women in childbearing age suffer from POI, and there is no optimal solution to improve ovarian function in patients with POI. Recently, in vitro activation (IVA) has been tried to treat the infertility of POI patients. It is well known that a certain number of dormant primordial follicles remain in the ovarian cortex of POI patients. IVA is to activate the dormant primordial follicles by blocking the Hippo signaling pathway through the fragmentation of the ovarian cortex, and activating the phosphatidylinositol 3 kinase-protein kinase B (PI3K-AKT) signaling pathway with AKT stimulators, so that the dormant primordial follicles can grow and develop into mature oocytes that can be used to assisted reproductive technology. It has been reported that follicle growth, and successful pregnancy and birth, are effectively induced via IVA. In this paper, we describe the regulatory effects of PI3K-AKT and Hippo signaling pathways on primordial follicle activation, and review the research progress of IVA treatment for POI.

Key words: Primary ovarian insufficiency;, Ovary;, Ovarian follicle;, Intercellular signaling peptides and proteins;, Signalingtransduction;, Phosphatidylinositol 3-kinases;, Protein kinases;, In vitro activation