Ovarian fibrosis: Mechanistic insights and emerging therapeutic horizons

• Multifactorial Pathogenesis: The paper provides a comprehensive analysis of the intricate mechanisms underlying ovarian fibrosis , encompassing epigenetic modifications , transcriptional alterations, inflammatory responses, oxidative stress , iron overload , and extracellular matrix remodeling. These factors interact with each other and collectively drive the progression of the disease. • Innovative Therapeutic Strategies: The paper evaluates the existing diagnostic and therapeutic methodologies and proposes an array of innovative therapeutic targets aimed at enhancing the effectiveness of treatment strategies, while underscoring the critical need for tailored, personalized treatment approaches. • The Role of Epigenetics in Ovarian Fibrosis: The study examines the impact of epigenetic abnormalities, including DNA methylation and histone acetylation, on gene expression and their role in the development of ovarian fibrosis. It identifies potential molecular targets for the development of new therapeutic approaches. • This paper will examine the role of inflammation and oxidative stress in this process. The paper elucidates the role of chronic low-grade inflammation and oxidative stress in ovarian fibrosis, particularly in the context of polycystic ovary syndrome (PCOS) and ovarian endometrioid cysts (OE). • Prospects for Precision Medicine : By integrating molecular mechanisms and clinical insights, this review aims to pave the way for precision medicine, enhancing the fertility and quality of life for women affected by ovarian fibrosis. Ovarian fibrosis is one of the common pathological manifestations of many gynecological diseases, such as premature ovarian failure (POF), ovarian endometrioid cyst (OE), polycystic ovary syndrome (PCOS), radiotherapy and chemotherapy complications, which can cause ovarian fibrosis. Specifically, ovarian damage exceeds the repair capacity of surrounding parenchymal cells. In order to maintain the integrity of the tissue structure, a large amount of extracellular matrix is produced and over-deposited, which eventually leads to irreversible repair of the ovary and ovarian fibrosis. The prevalence and complexity of ovarian fibrosis, as well as its significant impact on female reproductive health, make it particularly important to further study its influencing factors and develop effective treatment strategies. We reviewed the intricate mechanisms driving ovarian fibrosis, including epigenetic modifications, transcriptional alterations, inflammatory responses, oxidative stress, iron overload, and extracellular matrix remodeling. These factors synergistically advance the disease’s progression. This paper elucidates the aforementioned mechanisms to guide targeted therapy development. It also evaluates current diagnostic and therapeutic approaches and presents a list of novel targets for more effective treatment strategiesWe underscored the multifaceted nature of ovarian fibrosis and the imperative for tailored therapeutic approaches. By integrating molecular mechanisms with clinical insights, this review intends to set the stage for precision medicine, enhancing fertility and quality of life for women afflicted by ovarian fibrosis.