Fig. 2

The interconnected loop of glucose, lipids cholesterol and mitochondrial metabolism. A Well-function of glucose, lipids, cholesterol and mitochondrial metabolism in maintaining ovarian reserve. B Abnormal metabolism of glucose, fatty acids, and cholesterol in the DOR model. Glycolysis, the PPP, and the HBP were suppressed because of decreased GLUTs expression. Deficiencies of pyruvate, NADPH, and hyaluronic acid will lead to a lack of ATP, increased ROS level, damage of meiosis and DNA repair, and inhibition of GCs expansion. The activation of the polyol pathway can enhance sorbitol levels, leading to up-regulated SOD level and impairs mitochondrial function. A lack of fatty acids reduces the function of β-oxidation and the cholesterol synthesis in oocyte, which lead to insufficient of steroid hormones. Decreased estrogen cannot stimulate LH surge-induced β-oxidation. Insufficient of steroid hormones and ATP caused by these metabolic pathways can disturb follicle growth. Mitochondria is the pivot of glucose and lipids metabolism, and its dysfunction can impair these processes