TP53 and primary ovarian failure: Among these signaling pathways, the p53 pathway mediates the regulation of ovarian granulosa cell apoptosis by mRNA molecules, which in turn is involved in the pathogenesis of ovarian-related diseases, such as premature ovarian failure and polycystic ovary syndrome (PCOS) [49, 50]; the PI3K-Akt pathway mediates and regulates biological processes, such as cell proliferation and metabolism and the maintenance of genomic integrity, which in turn affects the recruitment and growth of primordial follicles.