title: BRCA Mutations, DNA Repair Deficiency, and Ovarian Aging.
abstract: Oocyte aging has a significant impact on reproductive outcomes both quantitatively and qualitatively. However, the molecular mechanisms underlying the age-related decline in reproductive success have not been fully addressed. BRCA is known to be involved in homologous DNA recombination and plays an essential role in double-strand DNA break repair. Given the growing body of laboratory and clinical evidence, we performed a systematic review on the current understanding of the role of DNA repair in human reproduction. We find that BRCA mutations negatively affect ovarian reserve based on convincing evidence from in vitro and in vivo results and prospective studies. Because decline in the function of the intact gene occurs at an earlier age, women with BRCA1 mutations exhibit accelerated ovarian aging, unlike those with BRCA2 mutations. However, because of the still robust function of the intact allele in younger women and because of the masking of most severe cases by prophylactic oophorectomy or cancer, it is less likely one would see an effect of BRCA mutations on fertility until later in reproductive age. The impact of BRCA2 mutations on reproductive function may be less visible because of the delayed decline in the function of normal BRCA2 allele. BRCA1 function and ataxia-telangiectasia-mutated (ATM)-mediated DNA repair may also be important in the pathogenesis of age-induced increase in aneuploidy. BRCA1 is required for meiotic spindle assembly, and cohesion function between sister chromatids is also regulated by ATM family member proteins. Taken together, these findings strongly suggest the implication of BRCA and DNA repair malfunction in ovarian aging.
authors.affiliation: Division of Reproductive Medicine and Laboratory of Molecular Reproduction & Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, New York Innovation Institute for Fertility Preservation and IVF, New York, New York koktay@fertilitypreservation.org.
authors.forename: Kutluk
authors.initials: K
authors.lastname: Oktay
authors.affiliation: Division of Reproductive Medicine and Laboratory of Molecular Reproduction & Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, New York Innovation Institute for Fertility Preservation and IVF, New York, New York.
authors.forename: Volkan
authors.initials: V
authors.lastname: Turan
authors.affiliation: Division of Reproductive Medicine and Laboratory of Molecular Reproduction & Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, New York Innovation Institute for Fertility Preservation and IVF, New York, New York.
authors.forename: Shiny
authors.initials: S
authors.lastname: Titus
authors.affiliation: Division of Reproductive Medicine and Laboratory of Molecular Reproduction & Fertility Preservation, Obstetrics and Gynecology, New York Medical College, Valhalla, New York Innovation Institute for Fertility Preservation and IVF, New York, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: Stobezki
authors.affiliation: Department of Cell Biology and Genetics, College of Life Sciences, Nankai University, Tianjin, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Liu
mesh_terms: D000818:Animals; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D004260:DNA Repair / Q000235:genetics*; D005260:Female; D005298:Fertility / Q000235:genetics*; D024522:Genes, BRCA2; D006801:Humans; D007246:Infertility / Q000235:genetics; D051379:Mice; D010053:Ovary / Q000254:growth & development*
chemical_list: D019313:BRCA1 Protein; D024682:BRCA2 Protein
keywords: BRCA; BRCA1; BRCA2; fertility; infertility; mechanisms of ovarian aging; mutations; oocyte; oocyte DNA repair; ovarian reserve