Etiological Mechanism of Decreased Ovarian Reserve Function: An Integrated Perspective of Traditional Chinese and Western Medicine Theories

Abstract

Diminished ovarian reserve (DOR), as an early pathological stage of premature ovarian failure, is characterized by a synergistic effect of physiological aging factors and pathological multifactors in modern medicine. The latter includes core elements such as genetic susceptibility, iatrogenic injury, immune regulation abnormalities, environmental exposure, and psychological stress. The theory of traditional Chinese medicine explains that the essence of its pathogenesis is “deficiency of kidney essence and deficiency of heaven and earth” - these two constitute the fundamental pathological basis for the occurrence and development of diseases, and run through the entire course of the disease; Among them, liver depression and qi stagnation are the key triggering factors, leading to the obstruction of qi and blood circulation and the formation of qi stagnation and blood stasis; The deficiency of qi and blood biochemistry caused by spleen deficiency and loss of luck further exacerbates the deficiency of the source; And blood stasis obstructing collaterals is not only a core pathological product, but also a key link in the deterioration of the disease. The four types of pathological elements mentioned above together constitute a dynamic pathological circulation system of “deficiency of the essence and excess of the substance”, ultimately disrupting the functional homeostasis of the “kidney-Tiangui-Chongren-uterus”. This multidimensional etiology and pathogenesis analysis provides a systematic theoretical basis for the integrated clinical diagnosis and treatment of DOR with traditional Chinese and Western medicine.