RT Journal Article T1 Genetic insights into biological mechanisms governing human ovarian ageing. A1 Ruth, Katherine S A1 Day, Felix R A1 Hussain, Jazib A1 Martínez-Marchal, Ana A1 Aiken, Catherine E A1 Azad, Ajuna A1 Thompson, Deborah J A1 Knoblochova, Lucie A1 Abe, Hironori A1 Tarry-Adkins, Jane L A1 Gonzalez, Javier Martin A1 Fontanillas, Pierre A1 Claringbould, Annique A1 Bakker, Olivier B A1 Sulem, Patrick A1 Walters, Robin G A1 Terao, Chikashi A1 Turon, Sandra A1 Horikoshi, Momoko A1 Lin, Kuang A1 Onland-Moret, N Charlotte A1 Sankar, Aditya A1 Hertz, Emil Peter Thrane A1 Timshel, Pascal N A1 Shukla, Vallari A1 Borup, Rehannah A1 Olsen, Kristina W A1 Aguilera, Paula A1 Ferrer-Roda, Mònica A1 Huang, Yan A1 Stankovic, Stasa A1 Timmers, Paul R H J A1 Ahearn, Thomas U A1 Alizadeh, Behrooz Z A1 Naderi, Elnaz A1 Andrulis, Irene L A1 Arnold, Alice M A1 Aronson, Kristan J A1 Augustinsson, Annelie A1 Bandinelli, Stefania A1 Barbieri, Caterina M A1 Beaumont, Robin N A1 Becher, Heiko A1 Beckmann, Matthias W A1 Benonisdottir, Stefania A1 Bergmann, Sven A1 Bochud, Murielle A1 Boerwinkle, Eric A1 Bojesen, Stig E A1 Bolla, Manjeet K A1 Boomsma, Dorret I A1 Bowker, Nicholas A1 Brody, Jennifer A A1 Broer, Linda A1 Buring, Julie E A1 Campbell, Archie A1 Campbell, Harry A1 Castelao, Jose E A1 Catamo, Eulalia A1 Chanock, Stephen J A1 Chenevix-Trench, Georgia A1 Ciullo, Marina A1 Corre, Tanguy A1 Couch, Fergus J A1 Cox, Angela A1 Crisponi, Laura A1 Cross, Simon S A1 Cucca, Francesco A1 Czene, Kamila A1 Smith, George Davey A1 de Geus, Eco J C N A1 de Mutsert, Renée A1 De Vivo, Immaculata A1 Demerath, Ellen W A1 Dennis, Joe A1 Dunning, Alison M A1 Dwek, Miriam A1 Eriksson, Mikael A1 Esko, Tõnu A1 Fasching, Peter A A1 Faul, Jessica D A1 Ferrucci, Luigi A1 Franceschini, Nora A1 Frayling, Timothy M A1 Gago-Dominguez, Manuela A1 Mezzavilla, Massimo A1 García-Closas, Montserrat A1 Gieger, Christian A1 Giles, Graham G A1 Grallert, Harald A1 Gudbjartsson, Daniel F A1 Gudnason, Vilmundur A1 Guénel, Pascal A1 Haiman, Christopher A A1 Håkansson, Niclas A1 Hall, Per A1 Hayward, Caroline A1 He, Chunyan A1 He, Wei A1 Heiss, Gerardo A1 Høffding, Miya K A1 Hopper, John L A1 Hottenga, Jouke J A1 Hu, Frank A1 Hunter, David A1 Ikram, Mohammad A A1 Jackson, Rebecca D A1 Joaquim, Micaella D R A1 John, Esther M A1 Joshi, Peter K A1 Karasik, David A1 Kardia, Sharon L R A1 Kartsonaki, Christiana A1 Karlsson, Robert A1 Kitahara, Cari M A1 Kolcic, Ivana A1 Kooperberg, Charles A1 Kraft, Peter A1 Kurian, Allison W A1 Kutalik, Zoltan A1 La Bianca, Martina A1 LaChance, Genevieve A1 Langenberg, Claudia A1 Launer, Lenore J A1 Laven, Joop S E A1 Lawlor, Deborah A A1 Le Marchand, Loic A1 Li, Jingmei A1 Lindblom, Annika A1 Lindstrom, Sara A1 Lindstrom, Tricia A1 Linet, Martha A1 Liu, YongMei A1 Liu, Simin A1 Luan, Jian'an A1 Mägi, Reedik A1 Magnusson, Patrik K E A1 Mangino, Massimo A1 Mannermaa, Arto A1 Marco, Brumat A1 Marten, Jonathan A1 Martin, Nicholas G A1 Mbarek, Hamdi A1 McKnight, Barbara A1 Medland, Sarah E A1 Meisinger, Christa A1 Meitinger, Thomas A1 Menni, Cristina A1 Metspalu, Andres A1 Milani, Lili A1 Milne, Roger L A1 Montgomery, Grant W A1 Mook-Kanamori, Dennis O A1 Mulas, Antonella A1 Mulligan, Anna M A1 Murray, Alison A1 Nalls, Mike A A1 Newman, Anne A1 Noordam, Raymond A1 Nutile, Teresa A1 Nyholt, Dale R A1 Olshan, Andrew F A1 Olsson, Håkan A1 Painter, Jodie N A1 Patel, Alpa V A1 Pedersen, Nancy L A1 Perjakova, Natalia A1 Peters, Annette A1 Peters, Ulrike A1 Pharoah, Paul D P A1 Polasek, Ozren A1 Porcu, Eleonora A1 Psaty, Bruce M A1 Rahman, Iffat A1 Rennert, Gad A1 Rennert, Hedy S A1 Ridker, Paul M A1 Ring, Susan M A1 Robino, Antonietta A1 Rose, Lynda M A1 Rosendaal, Frits R A1 Rossouw, Jacques A1 Rudan, Igor A1 Rueedi, Rico A1 Ruggiero, Daniela A1 Sala, Cinzia F A1 Saloustros, Emmanouil A1 Sandler, Dale P A1 Sanna, Serena A1 Sawyer, Elinor J A1 Sarnowski, Chloé A1 Schlessinger, David A1 Schmidt, Marjanka K A1 Schoemaker, Minouk J A1 Schraut, Katharina E A1 Scott, Christopher A1 Shekari, Saleh A1 Shrikhande, Amruta A1 Smith, Albert V A1 Smith, Blair H A1 Smith, Jennifer A A1 Sorice, Rossella A1 Southey, Melissa C A1 Spector, Tim D A1 Spinelli, John J A1 Stampfer, Meir A1 Stöckl, Doris A1 van Meurs, Joyce B J A1 Strauch, Konstantin A1 Styrkarsdottir, Unnur A1 Swerdlow, Anthony J A1 Tanaka, Toshiko A1 Teras, Lauren R A1 Teumer, Alexander A1 Þorsteinsdottir, Unnur A1 Timpson, Nicholas J A1 Toniolo, Daniela A1 Traglia, Michela A1 Troester, Melissa A A1 Truong, Thérèse A1 Tyrrell, Jessica A1 Uitterlinden, André G A1 Ulivi, Sheila A1 Vachon, Celine M A1 Vitart, Veronique A1 Völker, Uwe A1 Vollenweider, Peter A1 Völzke, Henry A1 Wang, Qin A1 Wareham, Nicholas J A1 Weinberg, Clarice R A1 Weir, David R A1 Wilcox, Amber N A1 van Dijk, Ko Willems A1 Willemsen, Gonneke A1 Wilson, James F A1 Wolffenbuttel, Bruce H R A1 Wolk, Alicja A1 Wood, Andrew R A1 Zhao, Wei A1 Zygmunt, Marek A1 Biobank-based Integrative Omics Study (BIOS) Consortium, A1 eQTLGen Consortium, A1 Biobank Japan Project, A1 China Kadoorie Biobank Collaborative Group, A1 kConFab Investigators, A1 LifeLines Cohort Study, A1 InterAct consortium, A1 23andMe Research Team, A1 Chen, Zhengming A1 Li, Liming A1 Franke, Lude A1 Burgess, Stephen A1 Deelen, Patrick A1 Pers, Tune H A1 Grøndahl, Marie Louise A1 Andersen, Claus Yding A1 Pujol, Anna A1 Lopez-Contreras, Andres J A1 Daniel, Jeremy A A1 Stefansson, Kari A1 Chang-Claude, Jenny A1 van der Schouw, Yvonne T A1 Lunetta, Kathryn L A1 Chasman, Daniel I A1 Easton, Douglas F A1 Visser, Jenny A A1 Ozanne, Susan E A1 Namekawa, Satoshi H A1 Solc, Petr A1 Murabito, Joanne M A1 Ong, Ken K A1 Hoffmann, Eva R A1 Murray, Anna A1 Roig, Ignasi A1 Perry, John R B AB 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. YR 2021 FD 2021-08-04 LK http://hdl.handle.net/10668/18292 UL http://hdl.handle.net/10668/18292 LA en DS RISalud RD May 9, 2025