Damage control in the female germline: Protecting primordial follicles

One of the major challenges faced by the oocytes of primordial follicles during their genesis and throughout their prolonged stasis is staying alive while maintaining high cytoplasmic and genomic quality, such that fertility is ensured and offspring are healthy. One way to manage this predicament is to employ a host of machinery to repair damage as it transpires. Furthermore, the primordial follicle must also be endowed with proapoptotic proteins so that if repair cannot occur, the oocyte is eliminated from the ovarian pool. This chapter focuses on the mechanisms by which primordial follicles maintain a balancing act between apoptotic elimination, repair, and tolerance to ensure quality control within the female germline. Additionally, as our understanding of the specific pathways involved in oocyte quality control improves, new opportunities are emerging to manipulate the size of the primordial follicle reserve to extend the natural reproductive lifespan and to preserve fertility during DNA-damaging anticancer treatment.