Publication Details
Abstract
The structural and functional integrity of the ovarian stroma, particularly its microvascular network, is essential for the proper functioning of the ovaries. Aging induces significant changes to stromal architecture that can impact folliculogenesis and female fertility. This study aims to investigate age-related remodelling of the ovarian stromal microvasculature and its correlation with follicular dynamics. Ovarian tissue samples were collected from women at various stages of the reproductive cycle, including the reproductive stage, perimenopause, and early menopause. Histological and immunohistochemical analyses were performed to evaluate microvascular density, stromal fibrosis, and vascular endothelial growth factor (VEGF) expression. Quantitative morphometric measurements were used to assess the correlation between stroma changes and follicle numbers. Our findings demonstrate a progressive decline in microvascular density, accompanied by increased stromal fibrosis, with advancing age. Reduced VEGF expression was observed in perimenopausal and early menopausal ovaries, suggesting impaired angiogenic signalling. Notably, these microvascular alterations were significantly associated with a reduction in the number of primordial and antral follicles, indicating a direct impact on folliculogenesis. These results provide novel insights into the mechanistic link between ovarian stromal microarchitecture and age-related fertility decline. A better understanding of the interplay between stromal microvascular remodelling and follicular development could inform strategies for fertility preservation and targeted therapies, as well as the development of biomarkers for ovarian ageing. Our study emphasises the importance of incorporating microvascular assessment into reproductive health evaluations and underscores the necessity for further research into interventions that could mitigate age-related ovarian functional decline.