SINGAPORE, May 2, 2025 -- Latest population studies have cast new light on genetic influences on women's reproductive lifespans and possible markers for the onset of chronic diseases.
Evidence is growing that conditions such as cardiovascular disease, type 2 diabetes, rheumatoid arthritis and neurodegenerative disorders are associated with reduced ovarian reserve, which refers to the number of healthy eggs remaining in a woman's ovaries as she ages.
In contrast, extended ovarian function appears to correlate with general good health and the possibility that greater reproductive success is an indicator of longevity.
The complex genetic interplay between the onset of menstruation and menopause came into sharp focus today at the 2025 Congress of the Asia Pacific Initiative on Reproduction (ASPIRE) in Singapore.
In a keynote address to the Congress, Professor Joop Laven, a world expert in reproductive endocrinology and infertility, suggested reproductive lifespan was associated with "survival".
He is the Professor of Reproductive Medicine at Erasmus Medical Centre, Rotterdam in The Netherlands, Past President of the Dutch Society of Reproductive Medicine, and a lead figure in Genome Wide Association Studies (GWAS).
The GWAS project has identified about 290 genetic determinants of reproductive ageing in a huge cohort of about 500,000 women of European ancestry.
In the project, Professor Laven has explored the genetic basis of hormonal conditions such as polycystic ovary syndrome (PCOS), along with premature ovarian insufficiency, menarche and menopause.
At the ASPIRE Congress, Professor Laven said women with PCOS tended to have the most effective genetic variants for DNA repair providing a "genetic advantage" of fertility beyond the fourth decade of life, when most women have exhausted their natural supply of eggs.
"Studies show PCOS women have better DNA repair and therefore produce better embryos at a later age compared to controls, and they have an extended reproductive life span," he explained.
"Women with PCOS have issues getting pregnant earlier in life. This may reduce the total number of children they have so they do not have a negative trade-off that a high number of children might have.
"Together with their longer lifespan this may represent an evolutionary advantage. Moreover, by having children later in life might reduce the incidence of PCOS in their offspring."
Professor Laven said studies indicated that over time, the gradual accumulation of DNA damage results in the exhaustion of cell renewal capacity and dysfunction in affected organs, ultimately accelerating cell death, commonly referred to as ageing.
"A similar erosion of the genome occurs within the ovaries," he said.
"The extent of DNA maintenance and repair also seems to have a determining effect on susceptibility to conditions including diabetes, cardiovascular disease and neurodegenerative disorders, such as Alzheimer's disease."
Professor Laven said sub-fertility should be monitored as it serves as a sensitive marker for susceptibility to these conditions highlighting the importance of patient follow up among those presenting for assisted reproduction.
"This seems to be in contrast to what most assisted reproductive technology clinics do," he added. "In general, clinics only report live birth rates as success.
"So, in many cases we are not following up our patients who may be susceptible to non-communicable diseases when we have the opportunity to develop preventive health strategies for them."
The ASPIRE Congress at the Suntec Convention and Exhibition Centre in Singapore has brought together over 2,000 scientists, clinicians, nurses and counsellors for a program that will help shape the future of fertility health care in the region and around the world.
For further information, go to www.ASPIRE2025.com
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