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Human Reproduction, Vol.25, No.12 pp. 2944–2954, 2010 Advanced Access publication on October 11, 2010 doi:10.1093/humrep/deq275 MINI-REVIEW Developments in reproductive biology and medicine Understanding follicle growth in vivo Ozgur Oktem* and Bulent Urman Women’s Health Center, Assisted Reproduction Unit, Vehbi Koc Foundation American Hospital, Guzelbahce Sok. No. 20 Nisantasi, 34365 Istanbul, Turkey *Correspondence address. Tel: +90-212-444-3-777; E-mail: ozgurok@amerikanhastanesi.org Submitted on May 15, 2010; resubmitted on September 4, 2010; accepted on September 8, 2010 abstract: Ovarian reserve is determined by the number of primordial follicles in the ovary. Quiescent primordial follicles are activated for growth and pass through stages of development before they reach the antral stage. Then a cohort of antral follicles is recruited for further growth, dominance and ovulation under the cyclic stimulation of gonadotrophins. What triggers the initiation of growth in primordial follicles has remained a mystery for decades. However, recent studies on mutant mouse models have shown that primordial follicles are maintained D o w in a dormant state by the actions of various inhibitory molecules to preserve the follicle pool, such as the transcription factor Foxo3a, PTEN
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