Vanishing returns on the investment that is the ovarian reserve

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EDITOR'S COMMENTARY

Vanishing returns on the investment that is the ovarian reserve David F. Albertini

Published online: 19 March 2013 # Springer Science+Business Media New York 2013

Among the wishes and dreams of an aging human population is the optimism that this freight train to finality could be forestalled or delayed so as to enjoy the benefits of youth. And, for more than a decade now, we have heard through the media that a virtual fountain of youth may be just around the corner. Pronouncements that the molecular and genetic bases for aging are becoming better understood (and implicitly treatable or manageable by drugs or lifestyle) allay the concerns of some. For those who had hoped for a time when replacement parts would be proffered from the likes of regenerative medicine, aspirations have been dampened by the fateful realization that we know less the more we discover and maybe it will not be so straightforward to simply cut and paste our way to eternal health. One of the most serious obstacles to grasping the essence of the aging problem is the lack of a tractable definition upon which good science can be based. Redefining and repurposing the discipline presently known as systems biology may help clarify matters. To the aged among us, systems biology is simply what the discipline of physiology has been for years. And in light of the aging problem, the gradual demise of organ systems as integrated entities reminds us that an extreme reductionist viewpoint may cause us to lose sight of the real problem-the whole organism. Accordingly we have come to appreciate that our bodies age not simply as a result of changes intrinsic to your favorite molecule, cell, tissue, or organ, but because the orchestration of our organ systems with one another breaks down. Capsule Proceedings from a recent workshop on the ovarian reserve raise interesting and important questions about the state of the field and future directions. Two recent studies shed new light on the mechanisms underlying follicle loss that could have therapeutic implications. D. F. Albertini (*) University of Kansas Medical Center, Kansas City, KS 66160, USA e-mail: [email protected]

Without a doubt, and the focus of this issue of JARG, the most striking case for system disintegration upon advancing age is the female reproductive system. Depletion of the ovarian follicle reserve is a major public health problem. And what causes the inevitable and periodic decline in follicles has been a lingering mystery in human biology since it was first recognized in animals and shown to be the irreversible course of action during the reproductive lifespan of women. If only the process could be delayed, then preservation of cardiovascular and musculoskeletal health for some additional decades might be achieved. And, with such an extended warranty, it follows that the ability to menstruate and bear children into a ripe old age would be a necessary (albeit controversial) consequence. Of course, extending a woman’s reproductive lifespan would require a way to maintain t