The increasing lifespan and the trend toward delayed first pregnancies have fueled interest in methods for extending the female reproductive lifespan. This review article analyzes current understanding of the physiological and molecular mechanisms of ovarian aging and explores contemporary anti-aging approaches aimed at improving ovarian reserve and sustaining fertility. Particular attention is given to the role of oxidative stress, mitochondrial dysfunction, epigenetic mechanisms, and innovative techniques such as platelet-rich plasma (PRP) therapy, stem cell application, senotherapy, and the prospects of "mitochondrial donation." Data from clinical and experimental studies are presented, suggesting effective strategies for preserving reproductive potential, which opens new avenues for infertility treatment, improved quality of life, and enabling women to pursue motherhood later in life. Conclusion: Ovarian aging is a multifactorial process reflecting a complex interplay of hormonal, genetic, epigenetic, and metabolic factors. Advances in reproductive medicine offer hope for extending the fertile window through innovative approaches: antioxidants, hormonal modulators (DHEA), PRP therapy, epigenetic modifiers, and cell-based technologies.Clinically validated approaches (CoQ10, melatonin, DHEA) are already helping to increase the chances of successful assisted reproductive technology (ART) outcomes in older women. Simultaneously, experimental methods such as "mitochondrial donation" and the use of mesenchymal stem cells (MSCs) require further investigation, as they have the potential to significantly impact the paradigm of age-related infertility treatment in the future.In the context of preventing ovarian aging and extending the reproductive lifespan, individualized monitoring of women at risk, as well as timely lifestyle modifications, are of particular importance. Further multidisciplinary research, integrating the capabilities of molecular biology, gerontology, reproductive medicine, and related fields, will enable the development of effective and safe anti-aging therapeutic strategies in gynecology.
Камоева et al. (Sun,) studied this question.