Reproductive longevity is essential for fertility and influences healthy ageing in women1,2, but insights into its underlying biological mechanisms and treatments to preserve it are limited. Here we identify 290 genetic determinants of ovarian ageing, assessed using normal variation in age at natural menopause (ANM) in about 200,000 women of European ancestry. These common alleles were associated with clinical extremes of ANM; women in the top 1% of genetic susceptibility have an equivalent risk of premature ovarian insufficiency to those carrying monogenic FMR1 premutations3. The identified loci implicate a broad range of DNA damage response (DDR) processes and include loss-of-function variants in key DDR-associated genes. Integration with experimental models demonstrates that these DDR processes act across the life-course to shape the ovarian reserve and its rate of depletion. Furthermore, we demonstrate that experimental manipulation of DDR pathways highlighted by human genetics increases fertility and extends reproductive life in mice. Causal inference analyses using the identified genetic variants indicate that extending reproductive life in women improves bone health and reduces risk of type 2 diabetes, but increases the risk of hormone-sensitive cancers. These findings provide insight into the mechanisms that govern ovarian ageing, when they act, and how they might be targeted by therapeutic approaches to extend fertility and prevent disease.

• MeSH
• alely MeSH
• celogenomová asociační studie MeSH
• checkpoint kinasa 1 genetika   MeSH
• checkpoint kinasa 2 genetika   MeSH
• diabetes mellitus 2. typu MeSH
• dieta MeSH
• dlouhověkost genetika   MeSH
• dospělí MeSH
• fertilita genetika   MeSH
• genetická predispozice k nemoci MeSH
• kosti a kostní tkáň metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• menopauza genetika   MeSH
• myši inbrední C57BL MeSH
• myši MeSH
• ovarium metabolismus   MeSH
• předčasná menopauza genetika   MeSH
• primární ovariální insuficience genetika   MeSH
• protein FMRP genetika   MeSH
• stárnutí genetika   MeSH
• uterus MeSH
• zdravé stárnutí genetika   MeSH
• zvířata MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• myši MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Dálný východ MeSH
• Evropa MeSH