Ovarian rejuvenation: Ways to restart the ovaries: A narrative review

Following the escalation of global infertility rate, female infertility has raised significant health concerns. Despite a myriad of treatment options being available to overcome female infertility, the majority remain nonspecific. Thus, ovarian dysfunction is recognized as a prominent pathophysiological condition, prompting the emergence of novel therapeutic strategies for ovarian rejuvenation. Several potential approaches include in vitro activation, artificial ovaries, telomerase reactivation, stem cell-based therapy, platelet activation therapy, mitigation of fibrosis and inflammation, and hormone replacement therapy, with the latter being rather conventional. Mounting evidence has suggested promising outcomes, such as restored hormone levels, increased follicle counts and maturation, and higher-quality oocytes. Besides, their working principles are based on countering fibrosis and inflammation, which often support the decline in ovarian function. While these methods aim to revive ovarian function under different circumstances, inconsistent findings are still being reported, emphasizing their uncertainty in practical terms. This review discusses novel therapies showing potential for ovarian rejuvenation and provides new insights into their specific roles in ameliorating ovarian conditions of various natures and at different stages.