THE WOMAN'S BIOLOGICAL CLOCK

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One of the most relevant topics in female reproduction is the so-called biological clock related to ovarian reserve. A term coined to indicate the number of residual follicles contained in the ovaries. In fact, the woman, unlike the man who continues to produce spermatozoa, is born with a predetermined number of follicles, a dowry, let's say, that progressively runs out, as in a countdown. A variable that is often underestimated, but which strongly conditions the duration of the reproductive life. At the same age, women with a low ovarian reserve have a higher risk of going through an early menopause.

'In recent years,' wrote Antonio La Marca, University of Modena and Reggio Emilia, 'we have learned to measure ovarian reserve very reliably, using ultrasound and laboratory instruments. The very rapid technological development we are witnessing imposes continuous revisions of the reference ranges for ovarian reserve, which obviously change as the methodology improves. A correct and early estimation of ovarian reserve can therefore make it possible to identify women at risk of a future premature menopause even at an early age, making it possible to inform them of this risk and to evaluate the implementation of fertility preservation methods'. The measurement of ovarian reserve is also fundamental when the doctor wants to treat the patient for infertility and has a high prognostic value, allowing the woman to be informed about the real possibility of pregnancy after specific treatments. These issues were discussed in Bologna last week at the congress on 'The Ovarian Reserve'.

Ample space was given to the discussion of the mechanisms leading to the formation of the 'follicular pool' in women, as well as to the analysis of the consequences on the ovarian reserve, including the effect of environmental pollution and its possible role in reducing female fertility. Put another way, there are a number of non-negligible conditions, including exposure to pollutants, and of course the age factor, that affect the ability to procreate, limiting potential year after year. Other negative factors, on the other hand, are unpredictable, such as the need to resort to a course of cancer therapies. These drawbacks can be remedied, one must be aware of the physiology of the man and the woman and contact a centre for medically assisted procreation (Pma) in good time, possibly resorting to the so-called cryopreservation of oocytes, to responsibly postpone the decision to plan a successful pregnancy.