LIANG Ya-Ping, HUANG Yun-Xuan, CHEN Jing
The ovary plays a critical role in maintaining female reproductive function and endocrine homeostasis, and its aging is closely associated with the decline in female fertility. With declining global fertility rates and delayed childbearing, ovarian aging has become a major focus in reproductive medicine. Hallmarks of ovarian aging include diminished ovarian reserve, reduced oocyte quality, hormonal dysregulation, and dysfunction of the hypothalamic-pituitary-ovarian axis. Multiple mechanisms, including DNA damage accumulation, telomere shortening, oxidative stress, mitochondrial dysfunction, chronic low-grade inflammation, and cellular senescence, interact to promote follicular depletion and oocyte impairment. In addition, dysregulation of key signaling pathways, such as PI3K/AKT/mTOR, SIRT, AMPK, and NF-κB, further contributes to granulosa cell apoptosis, follicular atresia, and ovarian microenvironment imbalance, thereby accelerating ovarian functional decline. Recent studies have highlighted the therapeutic potential of natural extracts in delaying ovarian aging due to their low toxicity, multi-target properties, and antioxidant and anti-inflammatory activities. Natural bioactive compounds, including polyphenols, flavonoids, and saponins, can ameliorate ovarian aging by scavenging reactive oxygen species, improving mitochondrial function, suppressing inflammation, and modulating related signaling pathways. This article provides a systematic review of the primary mechanisms underlying ovarian aging and the potential role of natural extracts in delaying ovarian aging. It focuses on summarizing mechanisms such as the accumulation of DNA damage, mitochondrial dysfunction, oxidative stress, inflammation, and imbalances in related signaling pathways. It also elucidates the intervention potential of natural extracts from the perspective of multi-target and multi-pathway regulation, thereby providing new research insights and potential targets for future studies on targeted interventions for ovarian aging.