Ovarian aging across the reproductive lifespan: fertility and public health implications

The aim of this study was to review the biological, clinical, ethical, and public health implications of ovarian aging as a growing global reproductive health challenge beyond infertility, emphasizing the need for improved fertility awareness and preventive strategies across the reproductive lifespan. A narrative review of the literature was conducted using PubMed, Cochrane Library, and Web of Science, focusing primarily on studies published within the last five years up to 2026 related to ovarian aging, fertility, reproductive rights, and public health. Relevant clinical studies, randomized controlled trials, and meta-analyses were qualitatively analyzed and synthesized. Ovarian aging is a progressive and predictable decline in oocyte quantity and quality, increasing the risk of infertility and adverse reproductive outcomes. The trend toward delayed childbearing, driven by educational, professional, and social factors, has amplified its relevance as a clinical and public health issue. Early detection and integration into preventive strategies may support reproductive autonomy and reduce the health and socioeconomic burden of delayed reproduction. Ovarian aging has implications beyond fertility, affecting long-term health and overall well-being. Recognizing it as a public health priority enables earlier risk identification, preventive strategies, and improved reproductive decision-making, while supporting integration into clinical practice and policy. Treating it as a global public health concern may improve risk identification, reproductive decision-making, and policy integration. However, claims regarding reductions in social, economic, and health burdens remain speculative, as defined mechanisms and intervention pathways are still lacking; future research should address these gaps.