Premature ovarian insufficiency

卵巢早衰
  • 文章类型: Journal Article
    本研究旨在评估针灸和电针对各种卵巢功能障碍的综合调节作用。
    我们系统地搜索了与多囊卵巢综合征(PCOS)有关的动物实验的文章,卵巢早衰(POF),卵巢早衰(POI),和围绝经期综合征(PMS)跨多个数据库,包括PubMed,WebofScience,科克伦图书馆,Embase,和四个中文数据库。搜索涵盖了从成立到2023年11月的时期。我们根据符合条件的文献对针刺组和模型组(未治疗)进行了比较分析。我们的主要结果包括血清性激素(黄体生成素,卵泡刺激素,睾酮,雌二醇,孕酮,和抗苗勒管激素)和卵巢重量。对二分类数据进行了综合,以建立显着治疗后改善的相对风险(RR),同时汇总连续数据以确定组间治疗后评分的标准化平均差(SMD).统计分析,包括敏感性分析,Egger\'stest,和修剪填充方法,使用Stata15.0软件执行。
    荟萃分析涵盖29篇文章,共涉及623只大鼠。与PCOS的大鼠模型相比,实验组显示血清LH水平降低,T和LH/FSH比值。然而,在AMH中没有观察到统计学上的显着差异,FSH,E2级别,两组之间的卵巢重量。在卵巢发育不全模型大鼠中,针刺和电针干预均与E2水平升高相关.然而,LH和FSH水平在两组之间没有显着差异。
    针灸或电针主要通过调节血清性激素促进卵巢功能的恢复,在各种类型的卵巢功能不全疾病中发挥调节作用。
    https://www.crd.约克。AC.uk/prospro/display_record.php?ID=CRD42022316279。
    UNASSIGNED: This study aims to assess the comprehensive and integrated modulatory effects of acupuncture and electroacupuncture on various ovarian dysfunctions.
    UNASSIGNED: We systematically searched for articles on animal experiments related to polycystic ovary syndrome (PCOS), premature ovarian failure (POF), premature ovarian insufficiency (POI), and perimenopausal syndrome (PMS) across multiple databases, including PubMed, Web of Science, Cochrane Library, Embase, and four Chinese language databases. The search covered the period from inception to November 2023. We conducted a comparative analysis between the acupuncture group and the model group (untreated) based on eligible literature. Our primary outcomes encompassed serum sex hormones (Luteinizing hormone, Follicle-stimulating hormone, Testosterone, Estradiol, Progesterone, and Anti-Müllerian hormone) and ovarian weight. Dichotomous data were synthesized to establish the relative risk (RR) of notable post-treatment improvement, while continuous data were pooled to determine the standardized mean difference (SMD) in post-treatment scores between the groups. Statistical analyses, including sensitivity analysis, Egger\'s test, and the trim-and-fill method, were executed using Stata 15.0 software.
    UNASSIGNED: The meta-analysis encompassed 29 articles involving a total of 623 rats. In comparison to rat models of PCOS, the experimental group exhibited a reduction in serum levels of LH, T and LH/FSH ratio. However, no statistically significant differences were observed in AMH, FSH, E2 levels, and ovarian weight between the two groups. In the ovarian hypoplasia model rats, both acupuncture and electroacupuncture interventions were associated with an increase in E2 levels. However, the levels of LH and FSH did not exhibit a significant difference between the two groups.
    UNASSIGNED: Acupuncture or electroacupuncture facilitates the restoration of ovarian function primarily through the modulation of serum sex hormones, exerting regulatory effects across various types of ovarian dysfunction disorders.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022316279.
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  • 文章类型: Journal Article
    背景:过早卵巢功能不全(POI)是指在40岁之前卵巢中卵母细胞的数量和/或质量急剧下降,是女性不孕的主要原因。POI的患病率逐年增加,并且趋于年轻。关于POI的病因及相关发病机制的研究还很有限。草药可以治疗许多妇科疾病。而草药在不孕症等生殖保健方面是有效的。近年来,已经发现细胞因子(CK)的免疫调节可以预防或干预POI,中药可以通过调节CK来治疗POI,以改善卵巢功能和生育能力。
    目的:本文就POI相关CK调控的分子机制进行综述,并报告了草药对POI的治疗效果,包括草药配方,单一草药,中药活性成分和针灸。本综述为POI的临床防治提供理论支持,为中药治疗POI的研究提供了新的思路。
    方法:我们收集了来自不同科学数据库的有关通过调节CK对POI的草药治疗作用的相关科学文章,包括PubMed,WebofScience,万方数据库,CNKI及其他出版物资源本评论中使用的搜索词包括,\'过早卵巢功能不全\',\'卵巢早衰(POF)\',\'不孕症\',\'草药\',\'针灸\',\'细胞因子\',\'白细胞介素(IL)\',“肿瘤坏死因子-α(TNF-α)”,\'干扰素-γ(IFN-γ)\',转化生长因子-β(TGF-β)血管内皮生长因子(VEGF)\'免疫\'和\'炎症\'。本文根据现有的实验和临床研究,对中药的治疗效果进行了总结和分析。
    结果:结果表明,草药通过CK(包括IL,TNF-α,INF-γ,VEGF,TGF-β等)和相关信号通路,调节生殖激素紊乱,减少卵巢炎症损伤,氧化应激,细胞凋亡和卵泡闭锁,改善卵巢病理损伤和卵巢储备功能。
    结论:这篇综述通过调节CK丰富了基于中药的POI治疗理论。应加强中药治疗POI的具体作用机制和临床研究,以促进中药在临床的应用,为POI的治疗提供新的思路和更好的选择。
    BACKGROUND: Premature ovarian insufficiency (POI) refers to a dramatic decrease in the number and/or quality of oocytes in the ovaries before the age of 40 years, and is a key cause of female infertility. The prevalence of POI has been increasing annually and tends to be younger. Researches on the etiology of POI and related pathogenesis are still very limited. Herbal medicine can treat many gynecological diseases. And herbal medicine is effective in reproductive health care such as infertility. In recent years, it has been found that immune modulation by cytokines (CK) can prevent or intervene in POI, and herbal medicine can treat POI by regulating CK to improve ovarian function and fertility.
    OBJECTIVE: This review presents an overview of the molecular mechanisms of regulation of POI related CK, and reports the therapeutic effect of herbal medicine on POI including herbal medicine formulas, single herbal medicine, herbal medicine active components and acupuncture. This review provides theoretical support for clinical prevention and treatment of POI, and provides new ideas for researches on herbal medicine treatment of POI.
    METHODS: We performed a collection of relevant scientific articles from different scientific databases regarding the therapeutic effect of herbal medicine on POI by regulating CK, including PubMed, Web of Science, Wanfang Database, CNKI and other publication resources. The search terms used in this review include, \'premature ovarian insufficiency\', \'premature ovarian failure (POF)\', \'infertility\', \'herbal medicine\', \'acupuncture\', \'cytokine\', \'interleukin (IL)\', \'tumor necrosis factor-α (TNF-α)\', \'interferon-γ (IFN-γ)\', \'transforming growth factor-β (TGF-β)\', \'vascular endothelial growth factor (VEGF)\', \'immune\' and \'inflammation\'. This review summarized and analyzed the therapeutic effect of herbal medicine according to the existing experimental and clinical researches.
    RESULTS: The results showed that herbal medicine treats POI through CK (including ILs, TNF-α, INF-γ, VEGF, TGF-β and others) and related signaling pathways, which regulates reproductive hormones disorder, reduces ovarian inflammatory damage, oxidative stress, apoptosis and follicular atresia, improves ovarian pathological damage and ovarian reserve function.
    CONCLUSIONS: This review enriches the theory of POI treatments based on herbal medicine by regulating CK. The specific mechanisms of action and clinical researches on the treatment of POI by herbal medicine should be strengthened in order to promote the application of herbal medicine in the clinic and provide new ideas and better choices for the treatment of POI.
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  • 文章类型: Journal Article
    过早卵巢功能不全(POI)严重影响女性的生殖健康。一些研究表明,POI似乎与心理和社会心理问题有关,但是POI是否会增加心理健康问题的风险尚未确定。因此,本荟萃分析对迄今为止发表的关于POI对女性心理健康影响的研究进行了初步系统评估.
    我们在2022年10月之前对有关该主题的研究进行了系统搜索。合并的优势比(ORs)和95%的置信区间(CIs)的患病率被用来评估POI对各种心理因素的影响,发表偏倚通过Egger检验进行评估。
    本荟萃分析共纳入15篇文章,包括5820名参与者。POI被发现与13个心理和心理社会问题的高风险相关,并分为3个领域:抑郁症(OR=1.61;95%CI:1.11-2.33),焦虑(OR=3.74;95%CI:1.78-7.87),生活质量差(OR=2.55,95%CI:1.63~3.97)。
    这项荟萃分析显示,患有POI的女性患抑郁症的风险增加,焦虑,生活质量差。POI的婚姻状况可能是抑郁症的影响因素,这意味着POI中的未婚状态是心理和社会心理问题的高风险。我们应该关注未婚女性POI的心理健康。
    UNASSIGNED: Premature ovarian insufficiency (POI) seriously affects the reproductive health of women. Several studies have been conducted to show that POI appears to be associated with psychological and psychosocial problems, but whether POI increases the risk of mental health problems has not been identified. Therefore, this meta-analysis provides a preliminary systematic assessment of the studies published to date on the impact of POI on women\'s mental health.
    UNASSIGNED: We implemented a systematic search for studies on this topic up to October 2022. Pooled odds ratios (ORs) and 95% confident intervals (CIs) of prevalence were used to assess the impacts of POI on various psychological factors, and the publication bias was assessed by Egger\'s test.
    UNASSIGNED: A total of 15 articles comprising 5820 participants were included in this meta-analysis. POI was found to be related to higher risk of 13 psychological and psychosocial problems identified and classified into 3 domains: depression (OR = 1.61; 95% CI: 1.11-2.33), anxiety (OR = 3.74; 95% CI: 1.78-7.87), and poor life quality (OR = 2.55, 95% CI: 1.63-3.97).
    UNASSIGNED: This meta-analysis reveals that women with POI have an increased risk of depression, anxiety, and poor life quality. The marital status of POI may be a possible influencing factor for depression, meaning that the unmarried status in POI is at high risk of psychological and psychosocial problems. We should pay attention to the mental health of women with POI who were unmarried.
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  • 文章类型: Systematic Review
    过早卵巢功能不全(POI)是一种罕见的疾病,其特征是40岁之前卵巢功能丧失。POI似乎与情绪障碍和性功能障碍有关。然而,缺乏关于POI对性功能影响的高质量证据.因此,我们进行了系统评价和荟萃分析,以评估患有POI的女性与没有患有POI的女性的性功能.截至2023年1月,对以下在线数据库进行了系统搜索:EMBASE,Medline(Ovid),WebofScience,科克伦,PsychInfo,谷歌学者。随机效应模型用于分析,数据报告为对冲和95%置信区间,并对异质性风险进行了评估。本研究的方案在PROSPERO(CRD42023437203)注册。共有10项研究纳入系统评价,5项研究纳入352名患有POI的女性。十项研究中有八项得出结论,患有POI的女性性功能降低。发现总体中等对冲效应大小为-0.72(范围在-0.20和-1.29之间)有利于对照女性,中度异质性(I2=64%)。对女性进行系统性激素替代疗法(HRT)的分层研究显示,对冲效应的大小甚至更高,为-0.82(95%CI-1.18,-0.47)。总之,与对照组女性相比,POI女性的性功能降低。应与患有POI的女性讨论性功能,并应向她们提供心理性咨询。
    Premature ovarian insufficiency (POI) is a rare condition characterized by loss of ovarian function before the age of 40. POI seems associated with mood disorders and sexual dysfunction. However, there is a lack of high-quality evidence relating to the impact of POI on sexual function. Therefore, we conducted a systematic review and meta-analysis to evaluate sexual function in women with POI compared to women without the condition. The following online databases were systematically searched up to January 2023: EMBASE, Medline (Ovid), Web of Science, Cochrane, PsychInfo, and Google Scholar. Random effects models were used for analyses, with data reported as Hedges\' g and 95 % confidence interval, and the risk of heterogeneity was evaluated. The protocol of this study was registered with PROSPERO (CRD42023437203). A total of 10 studies were included in the systematic review and 5 studies involving 352 women with POI were included in the meta-analysis. Eight of the ten studies concluded that women with POI have reduced sexual function. An overall medium Hedges\' g effect size of -0.72 was found (ranging between -0.20 and -1.29) in favor of control women, with moderate heterogeneity (I2 = 64 %). Stratified studies of women on systemic hormone replacement therapy (HRT) showed an even higher Hedges\' g effect size, of -0.82 (95 % CI -1.18, -0.47). In conclusion, sexual function in women with POI is reduced compared with control women. Sexual function should be discussed with women with POI and they should be offered psychosexual counseling.
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  • 文章类型: Meta-Analysis
    目的:综合评价低出生体重对卵巢早衰的影响。
    方法:我们通过搜索MEDLINE对文献进行了系统回顾,EMBASE,WebofScience,Scopus,万方和CNKI截至2023年8月。所有包括出生体重作为暴露量和卵巢功能早衰作为结果的队列和病例对照研究都包括在分析中。使用反向方差加权meta分析将数据与固定和随机效应模型相结合,并评估研究之间的异质性。我们使用纽卡斯尔渥太华量表并使用Egger方法测试发表偏倚来评估偏倚风险。所有统计分析均使用R软件进行。
    结果:这篇综述包括5篇文章。共包括2248594名妇女,包括21,813例(1%)卵巢早衰,150,743例低出生体重,和220,703例巨大儿。我们发现了强有力的证据,改变了先前的评价结果,即与正常出生体重相比,低出生体重与成年期卵巢早衰风险增加有关(OR=1.15,95CI1.09-1.22)。未发现巨大儿对卵巢早衰的影响。
    结论:我们的荟萃分析显示了低出生体重与卵巢功能不全之间存在关联的有力证据。应通过多种方法减少低出生体重的发生,避免卵巢早衰的发生。
    OBJECTIVE: To comprehensively evaluate the effect of low birth weight on premature ovarian insufficiency.
    METHODS: We performed a systematic review of the literature by searching MEDLINE, EMBASE, Web of Science, Scopus, Wanfang and CNKI up to August 2023. All cohort and case-control studies that included birth weight as an exposure and premature ovarian insufficiency as an outcome were included in the analysis. Data were combined using inverse-variance weighted meta-analysis with fixed and random effects models and between-study heterogeneity evaluated. We evaluated risk of bias using the Newcastle Ottawa Scale and using Egger\'s method to test publication bias. All statistical analyses were performed with the use of R software.
    RESULTS: Five articles were included in the review. A total of 2,248,594 women were included, including 21,813 (1%) cases of premature ovarian insufficiency, 150,743 cases of low birth weight, and 220,703 cases of macrosomia. We found strong evidence that changed the results of the previous review that low birth weight is associated with an increased risk of premature ovarian insufficiency (OR = 1.15, 95%CI 1.09-1.22) in adulthood compared with normal birth weight. No effect of macrosomia on premature ovarian insufficiency was found.
    CONCLUSIONS: Our meta-analysis showed strong evidence of an association between low birth weight and premature ovarian insufficiency. We should reduce the occurrence of low birth weight by various methods to avoid the occurrence of premature ovarian insufficiency.
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  • 文章类型: Journal Article
    背景:过早卵巢功能不全(POI)是一种以40岁以下女性卵巢功能障碍为特征的临床疾病。大多数POI病例的病因仍然不明,被认为是多因素的,包括自身免疫等因素,新陈代谢,感染,和遗传学。POI表现出显著的遗传异质性,它可能是由染色体异常和单基因缺陷引起的。
    方法:研究参与者,一个33岁的女人,有两年前开始的月经不调史,进展为经期延长并最终停止。参与者表现出X染色体的重排,通过全外显子组测序(WES)结合细胞染色体检测,其特征是长臂上的杂合性重复和短臂上的杂合性缺失。
    结论:本研究扩展了X染色体异常导致的与POI相关的突变谱。WES-拷贝数变异分析,结合染色体核型分析和其他检测技术,可以更全面地了解复杂的单系统或多系统疾病的遗传景观。
    BACKGROUND: Premature ovarian insufficiency (POI) is a clinical condition characterized by ovarian dysfunction in women under 40. The etiology of most POI cases remains unidentified and is believed to be multifactorial, including factors such as autoimmunity, metabolism, infection, and genetics. POI exhibits significant genetic heterogeneity, and it can result from chromosomal abnormalities and monogenic defects.
    METHODS: The study participant, a 33-year-old woman, presented with a history of irregular menstruation that commenced two years ago, progressing to prolonged menstrual episodes and eventual cessation. The participant exhibits a rearrangement of the X chromosome, characterized by heterozygosity duplication on the long arm and heterozygosity deletion on the short arm by whole exome sequencing(WES) combined with cell chromosome detection.
    CONCLUSIONS: This study expands the spectrum of mutations associated with POI resulting from X chromosomal abnormalities. WES-Copy number variation analysis, in conjunction with chromosome karyotype analysis and other detection techniques, can provide a more comprehensive understanding of the genetic landscape underlying complex single or multi-system diseases.
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  • 文章类型: Journal Article
    背景:世界卫生组织(WHO)排卵障碍分类系统是在50年前产生的,根据国际共识,已由国际妇产科联合会(FIGO)更新。
    目的:这篇综述详细概述了FIGOHyPO-P(下丘脑,垂体,卵巢,PCOS)分类,对每个原因进行简明描述,从而为诊断和管理提供了系统的方法。
    方法:我们在英语文献中搜索了PubMed数据库中已发表的文章,直到2022年10月,其中包含关键词排卵障碍;排卵功能障碍;无排卵,以及FIGOHyPO-P分类中的每个子标题。我们没有包括摘要或会议记录,因为数据通常很难评估。
    结果:我们对所有排卵障碍进行了最全面的综述,根据逻辑FIGO分类系统地出版。
    结论:提高对个体排卵功能障碍的诊断将显著影响临床实践,使医疗保健从业人员能够做出精确的诊断并计划适当的管理。
    BACKGROUND: The World Health Organization (WHO) system for the classification of disorders of ovulation was produced 50 years ago and, by international consensus, has been updated by the International Federation of Gynecology and Obstetrics (FIGO).
    OBJECTIVE: This review outlines in detail each component of the FIGO HyPO-P (hypothalamic, pituitary, ovarian, PCOS) classification with a concise description of each cause, and thereby provides a systematic method for diagnosis and management.
    METHODS: We searched the published articles in the PubMed database in the English-language literature until October 2022, containing the keywords ovulatory disorders; ovulatory dysfunction; anovulation, and each subheading in the FIGO HyPO-P classification. We did not include abstracts or conference proceedings because the data are usually difficult to assess.
    RESULTS: We present the most comprehensive review of all disorders of ovulation, published systematically according to the logical FIGO classification.
    CONCLUSIONS: Improving the diagnosis of an individual\'s ovulatory dysfunction will significantly impact clinical practice by enabling healthcare practitioners to make a precise diagnosis and plan appropriate management.
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  • 文章类型: Journal Article
    卵巢功能有些衰竭,比如卵泡发生和卵子发生,会引起各种不孕症相关的问题,包括多囊卵巢综合征(PCOS)和卵巢早衰(POI)。PCOS影响8%至20%的女性;而POI发生在至少1%的女性中。遗憾的是,目前对这些疾病的治疗还不够有效,找到合适的策略仍然是一个难题。管理和治疗这些疾病的有用策略之一是了解其发病机理和机制。最近,已经宣布microRNAs(miRNAs)的异常表达,作为非编码RNA的子集,参与生殖疾病的发病机制。在miRNA中,miRNA-21在PCOS和POI发病机制中的作用已在一些文献中得到强调;本小型综述的目的是总结与该miRNA和其他有效microRNAs在卵巢正常或异常功能中的功能相关的证据(即,PCOS和POI)具有机械洞察力。
    Some failures in ovary function, like folliculogenesis and oogenesis, can give rise to various infertility-associated problems, including polycystic ovary syndrome (PCOS) and premature ovarian insufficiency (POI). PCOS influences 8 to 20% of women; while POI occurs in at least 1% of all women. Regrettably, the current therapies for these diseases have not sufficiently been effective, and finding a suitable strategy is still a puzzle. One of the helpful strategies for managing and treating these disorders is understanding the contributing pathogenesis and mechanisms. Recently, it has been declared that abnormal expression of microRNAs (miRNAs), as a subset of non-coding RNAs, is involved in the pathogenesis of reproductive diseases. Among the miRNAs, the roles of miRNA-21 in the pathogenesis of PCOS and POI have been highlighted in some documents; hence, the purpose of this mini-review was to summarize the evidences in conjunction with the functions of this miRNA and other effective microRNAs in the normal or abnormal functions of the ovary (i.e., PCOS and POI) with a mechanistic insight.
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  • 文章类型: Journal Article
    进行了系统评价和荟萃分析,以确定是否有一部分POI患者在卵巢破裂后更有可能显示卵泡生长,以进行卵泡激活(OFFA)或体外激活(IVA)。5项研究符合荟萃分析的纳入标准,共有164名患者。43例患者表现为卵泡发育(26.21%)。其中,妊娠率为35.58%(11/43),活产率为20.93%(9/43)。我们的荟萃分析显示年龄与卵泡生长无关。然而,较低基线FSH,闭经/诊断持续时间较低,活检中残留的卵泡对卵泡发育有统计学意义。先前提到的具有基础特征的患者在OFFA或IVA后可能有更多机会显示卵泡生长。考虑到大约20%的卵泡生长患者有活产,这些结果非常有希望。鉴于证据的总体确定性,未来的研究需要证实上述结果.
    A systematic review and meta-analysis were performed to identify if there is a subset of patients with POI who are more likely to show follicular growth after ovarian fragmentation for follicular activation (OFFA) or in vitro activation (IVA). Five studies met inclusion criteria for meta-analysis with a total of 164 patients. Forty-three patients showed follicle development (26.21%). Of those, the pregnancy rate was 35.58% (11/43) and the live birth rate was 20.93% (9/43). Our meta-analysis showed that age was not associated with follicle growth. However, lower baseline FSH, lower duration of amenorrhea/diagnosis, and presence of follicles remaining in biopsy were statistically significant for follicle development. Patients with basal characteristics mentioned before may have more chances to show follicle growth after OFFA or IVA. Taking into account that approximately 20% of patients with follicle growth had live birth, these results are very promising. Given the overall certainty of evidence, future studies are needed to confirm said results.
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  • 文章类型: Journal Article
    过早卵巢功能不全(POI)是卵泡数量和卵母细胞质量逐渐降低的一种状况。这导致雌激素分泌紊乱和卵泡发育异常,这可能导致相关疾病,更年期的早期发作,性功能障碍,心血管疾病的风险增加,骨质疏松,和抑郁症,在其他人中。这种疾病严重影响受影响妇女的身心健康和整体生活质量。遗传异常等因素,卵巢切除术,恶性肿瘤的放射治疗,特发性条件,和不健康的生活方式,包括吸烟,可以加速卵泡池的消耗和更年期的开始。已经对烟草烟雾对卵巢的有害影响进行了广泛的研究。本文旨在回顾烟草烟雾对POI影响的研究进展,体内和体外。此外,我们探讨了烟草烟雾中常见毒物的潜在不利影响,如多环芳烃(PAHs),像镉这样的重金属,生物碱,如尼古丁及其主要代谢产物可替宁,苯并[a]芘,和芳香胺。除了讨论有毒物质,本文还对POI相关并发症及治疗方法的研究和应用现状进行了综述。这些发现将有助于开发更精确的POI治疗方法,为提高受此影响的妇女的长期生活质量提供理论支持。
    Premature ovarian insufficiency (POI) is a condition in which the quantity of follicles and the quality of oocytes gradually decrease. This results in an estrogen secretion disorder and abnormal follicle development, which can lead to related diseases, early onset of menopause, sexual dysfunction, and an increased risk of cardiovascular issues, osteoporosis, and depression, among others. This disease significantly impacts the physical and mental health and overall quality of life of affected women. Factors such as genetic abnormalities, oophorectomy, radiotherapy for malignancy, idiopathic conditions, and an unhealthy lifestyle, including smoking, can accelerate the depletion of the follicular pool and the onset of menopause. Extensive research has been conducted on the detrimental effects of tobacco smoke on the ovaries. This article aims to review the advancements in understanding the impact of tobacco smoke on POI, both in vivo and in vitro. Furthermore, we explore the potential adverse effects of common toxicants found in tobacco smoke, such as polycyclic aromatic hydrocarbons (PAHs), heavy metals like cadmium, alkaloids like nicotine and its major metabolite cotinine, benzo[a]pyrene, and aromatic amines. In addition to discussing the toxicants, this article also reviews the complications associated with POI and the current state of research and application of treatment methods. These findings will contribute to the development of more precise treatments for POI, offering theoretical support for enhancing the long-term quality of life for women affected by this condition.
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