Follicular atresia: Its features as predictive markers for the outcome of assisted reproduction

The mammalian ovary is an extremely dynamic organ in which excessive or defective follicles are rapidly and effectively eliminated continuously throughout reproductive life. More than 99% of follicles disappear, due to apoptosis of granulosa cells, and only one or few of the surviving follicles successfully complete the path to ovulation. The balance between signals for cell death and survival determines the destiny of the follicles. In this review, we provide a short overview of the role of programmed cell death essentially in adult folliculogenesis. We highlight molecules involved in regulation of granulosa cell apoptosis. We further discuss the potential use of scores for apoptosis in granulosa cells and characteristics of follicular fluid as prognostic markers for predicting the outcome of assisted reproduction. (C) 2010 Elsevier Masson SAS. All rights reserved.