Cholesterol is an important substrate for the synthesis of ovarian sex
hormones and has an important influence on follicular development. The cholesterol in
follicular fluid is mainly derived from plasma. High-density lipoprotein (HDL) and lowdensity
lipoprotein (LDL) play important roles in ovarian cholesterol transport. The
knockout of related receptors in the mammalian HDL and LDL pathways results in the
reduction or absence of fertility, leading us to support the importance of cholesterol
homeostasis in the ovary. However, little is known about ovarian cholesterol metabolism
and the complex regulation of its homeostasis. Here, we reviewed the cholesterol
metabolism in the ovary and speculated that regardless of the functioning of cholesterol
metabolism in the system or the ovarian microenvironment, an imbalance in cholesterol
homeostasis is likely to have an adverse effect on ovarian structure and function.
Keywords: Ovarian follicles, lipoprotein, sterol carrier protein 2, steroidogenesis, cholesterol homeostasis, fertility.
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