In recent years, ovarian tissue cryopreservation has rapidly developed as a successful method for preserving the fertility of girls and young women with cancer or benign conditions requiring gonadotoxic therapy, and is now becoming widely recognized as an effective alternative to oocyte and embryo freezing when not feasible. Primordial follicles are the most abundant population of follicles in the ovary, and their relatively quiescent metabolism makes them more resistant to cryoinjury. This dormant pool represents a key target for fertility preservation strategies as a resource for generating high-quality oocytes. However, development of mature, competent oocytes derived from primordial follicles is challenging, particularly in larger mammals. One of the main barriers is the substantial knowledge gap regarding the regulation of the balance between dormancy and activation of primordial follicles to initiate their growing phase. In addition, experimental and clinical factors also affect dormant follicle demise, while the mechanisms involved remain largely to be elucidated. Moreover, most of our basic knowledge of these processes comes from rodent studies and should be extrapolated to humans with caution, considering the differences between species in the reproductive field. Overcoming these obstacles is essential to improving both the quantity and the quality of mature oocytes available for further fertilization, and may have valuable biological and clinical applications, especially in fertility preservation procedures. This review provides an update on current knowledge of mammalian primordial follicle activation under both physiological and nonphysiological conditions, and discusses implications for fertility preservation and priorities for future research.

中文翻译：

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非生理性卵巢原始卵泡激活对生育力保存的影响。

近年来，卵巢组织冷冻保存作为一种成功的方法来保存患有癌症或需要性腺毒性治疗的良性疾病的女孩和年轻女性的生育能力，并且现在被广泛认为是不可行时卵母细胞和胚胎冷冻的有效替代方法. 原始卵泡是卵巢中最丰富的卵泡群体，它们相对静止的新陈代谢使它们更能抵抗冷冻损伤。这个休眠池代表了生育力保存策略的关键目标，作为产生高质量卵母细胞的资源。然而，从原始卵泡中发育成熟、有能力的卵母细胞具有挑战性，尤其是在大型哺乳动物中。主要障碍之一是关于调节休眠和激活原始卵泡以启动其生长阶段之间的平衡的巨大知识差距。此外，实验和临床因素也会影响休眠卵泡的死亡，而所涉及的机制仍有待阐明。此外，我们对这些过程的大部分基本知识来自啮齿动物研究，考虑到生殖领域物种之间的差异，应谨慎外推到人类。克服这些障碍对于提高可用于进一步受精的成熟卵母细胞的数量和质量至关重要，并且可能具有有价值的生物学和临床应用，特别是在生育保存程序中。