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Premature ovarian insufficiency (POI) is impairment of the ovaries and how they work before the age of 40 years. It can be caused by multiple factors, one being genetic. Genes and their influence determine the initial number of the primordial follicles, impact on the rate of follicular atresia, and are impactful on the age of menopause.
Oocytes are then able to mature within the follicle through meiosis. In humans with ovaries, this process occurs continuously, as they are born with a finite number of follicles (between 500,000-1,000,000 follicles), and about 99% of follicles undergo atresia. [4] Only one follicle will be mature enough to release an egg and may be fertilized. [5]
In vitro fertilisation (IVF) is a process of fertilisation in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating a woman's ovulatory process, then removing an ovum or ova (egg or eggs) from her ovaries and enabling a man's sperm to fertilise them in a culture medium in a laboratory.
The underlying mechanism is that, with the GnRH antagonist protocol, initial follicular recruitment and selection is undertaken by endogenous endocrine factors prior to starting the exogenous hyperstimulation, resulting in a smaller number of growing follicles when compared with the standard long GnRH agonist protocol. [9]
These multiple follicles can be taken out by oocyte retrieval (egg collection) for use in in vitro fertilisation (IVF), or be given time to ovulate, resulting in superovulation which is the ovulation of a larger-than-normal number of eggs, [2] generally in the sense of at least two.
Women starting at around age 42 to 45 are typically advised not to proceed with IVF with their own eggs because older eggs have a higher chance of abnormalities. Gene variant protects against ...
In the U.S., we’re delaying pregnancy even longer (the average age for a first-time mom has increased from 25.6 years old in 2011 to 27.3 years old in 2021), and the number of women giving birth ...
After ovulation, the follicle remnant is transformed into a progesterone-producing corpus luteum, which shrinks and disappears after approximately 12–14 days. In PCOS, there is a so-called "follicular arrest"; i.e., several follicles develop to a size of 5–7 mm, but not further. No single follicle reaches the preovulatory size (16 mm or more).