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Vertebrate reproductive science and technology
REVIEW (Open Access)

Genetic regulation of ovulation rate and multiple births

G. W. Montgomery https://orcid.org/0000-0002-4140-8139 A *
+ Author Affiliations
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A Institute for Molecular Bioscience, The University of Queensland, Brisbane, Qld, Australia.

* Correspondence to: g.montgomery1@uq.edu.au

Handling Editor: Jennifer Juengel

Reproduction, Fertility and Development 36, RD24083 https://doi.org/10.1071/RD24083
Submitted: 10 June 2024  Accepted: 9 August 2024  Published online: 2 September 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Ovulation rate in many mammalian species is controlled to regulate the numbers of offspring and maximise reproductive success. Pathways that regulate ovulation rate still respond to genetic and environmental factors and show considerable variation within and between species. Genetic segregation, positional cloning, and association studies have discovered numerous mutations and genetic risk factors that contribute to this variation. Notable among the discoveries has been the role of mutations in bone morphogenetic protein 15 (BMP15), growth differentiation factor 9 (GDF9) and bone morphogenetic protein receptor type 1B (BMPR1B) from the intra-ovarian signalling pathway contributing to the evidence that signalling from the oocyte is the key driver in follicle regulation rather than circulating gonadotrophin concentrations. Multiple variants in different domains of BMP15 and GDF9 result in partial or complete loss of function of the proteins providing insights into their functional roles and differential regulation contributing to species differences in ovulation rate. Early success encouraged many more studies in prolific strains of sheep, cattle and goats providing a valuable catalogue of genetic variants of large effect increasing ovulation rate and litter size. More recently, genetic association studies are beginning to identify genetic risk factors with smaller effects. Most genes implicated are from pathways with defined roles in regulation of the ovarian function. However, some genomic regions suggest regulation by novel genes. Continuing genetic and related functional studies will add further to our understanding of the detailed regulation of ovulation rate and litter size with implications for health and animal production systems.

Keywords: genetic association, genetic regulation, GWAS, litter size, multiple birth, mutation screening, ovulation rate, twinning.

Introduction

The frequency of twins or higher order multiple births varies substantially across species and understanding factors controlling twinning is important for health and managing production systems for livestock. Dizygotic twin pregnancies in women are associated with a higher frequency of preterm birth, gestational hypertension, and preeclampsia with additional complications in monozygotic twin pregnancies (D’Alton and Breslin 2020). Twinning in cattle can be linked to health and reproductive problems in both mothers and offspring due to increased embryo/fetal losses, malpresentation and dystocia, and the high frequency of freemartins in female twins born as cotwins to males (Vinet et al. 2012; Lett and Kirkpatrick 2022). In contrast, an increased frequency of twins in sheep contributes to farm income and profitability in many productions systems (Amer et al. 1999).

This Collection is dedicated to the memory of Professor Ken McNatty and Professor Rex Scaramuzzi for their substantial contributions to understanding the biology of the ovary and how regulation of ovarian follicle development contributes to the control of ovulation rate and litter size within and between species. I am pleased to contribute to the Collection and pay tribute to their influence on this field. In my early career, I worked closely with Ken McNatty and we published joint papers on ovarian activity in cattle (McNatty et al. 1984a, 1984b) and genetic mutations controlling ovulation rate (Montgomery et al. 1992a; Galloway et al. 2000; Wilson et al. 2001). Ken was a role model and mentor for many and his influence for me extended well beyond our collaborative studies. His approach to research was an inspiration with his focus on high quality science and embracing new technologies to answer his research questions.

In the quest to understand factors controlling ovulation rate, I began working with Professor Diana Hill at the Department of Biochemistry, University of Otago to take a different approach and apply emerging methods in human gene mapping to applications in livestock genetics. We conducted preliminary studies from 1987, and together established the AgResearch Molecular Biology Unit (MBU) in 1989 with the ambitious goal of applying gene mapping techniques to map and clone the mutation responsible for increased ovulation rate and litter size in the Booroola strain of Merino (Davis et al. 1982; Piper and Bindon 1982). Ken McNatty was a strong supporter for our establishment of the AgResearch MBU and it is likely that without Ken’s strong support, this initiative might never have eventuated. We continued to work with Ken and his team as our mapping studies progressed.

Genetic studies of twinning

Mapping genetic variants increasing litter size in sheep and goats

The Booroola FecB variant

The Booroola strain of Merino selected and developed by the Seeares brothers of ‘Booroola’, Cooma, New South Wales, Australia was unique at the time because the exceptional reproductive performance was shown to segregate as a single gene (Davis et al. 1982; Piper and Bindon 1982). This locus was assigned the symbol FecB by the Committee on Gene Nomenclature of Sheep and Goats and the evidence for segregation of a single gene with a major phenotypic effect on ovulation rate and litter size was of great interest. We were curious to understand the mechanism for this exceptional lambing performance.

Our program in the AgResearch MBU to map and clone the gene responsible for the FecB locus was ambitious since few DNA based genetic markers had been described and there was no genetic linkage map for sheep. The first tasks were to generate segregating pedigrees, obtain DNA samples, and identify genetic markers to screen for co-segregation with the twinning phenotype. We mated heterozygous males with non-carrier females and collected DNA samples from the sires and offspring (Montgomery et al. 1993). Our strategy was to develop DNA markers for both known genes, allowing us to easily relate the sheep genetic map across to the developing human and mouse gene maps, and to identify polymorphic markers with greater power for the linkage analysis. To this end, we focussed on restriction fragment length polymorphisms (RFLPs) using a selection of human, cattle, and sheep cDNA probes (Montgomery et al. 1992b) and highly polymorphic dinucleotide microsatellite markers (Montgomery et al. 1992b; Crawford et al. 1994). The markers were screened in our Booroola pedigrees and in nine mapping pedigrees with three generations to simultaneously evaluate linkage to the FecB locus (Montgomery et al. 1993) and build the sheep genetic map (Crawford et al. 1995).

Initial RFLP markers for candidate genes from the reproductive pathway did not identify linkage to the FecB locus and the first evidence for linkage came with an anonymous microsatellite marker OarAE101 (Montgomery et al. 1993). However, our joint strategy of microsatellite and gene-based markers was successful since joint linkage between OarAE101 and RFLP markers mapped the linkage region to an equivalent region on human chromosome 4q (Montgomery et al. 1993). Comparison with human and mouse maps identified likely genes we expected to find in the sheep linkage region. These included the GNRHR (gonadotrophin releasing hormone receptor), but an RFLP marker for GNRHR in sheep mapped this gene outside the linkage region for FecB (Montgomery et al. 1995).

Subsequent gene mapping determined that the FecB locus mapped to a narrow region of sheep chromosome 6. BMPR1B (bone morphogenetic protein receptor type 1B) became a ‘hot’ candidate when it was mapped to the equivalent region on human chromosome 4q22-24 because of the emerging role of the TGF-β signalling pathway in the ovary (Åström et al. 1999). Three groups including our own soon reported that a point mutation in BMPR1B resulting in a change from a glutamine (neutral/polar amino acid) to an arginine (basic amino acid) at position 249 of the protein (Q249R) in the intracellular kinase signalling domain was responsible for the increased ovulation rate and litter size at the FecB locus (Mulsant et al. 2001; Souza et al. 2001; Wilson et al. 2001). Molecular modelling suggests the Q249R mutation may enhance the interaction between FKBP12 (FKBP Prolyl Isomerase 1A) and BMPR1B, leading to a stronger inhibition of receptor activity (Mulsant et al. 2001).

Genetic variants of large effect in other genes

Evidence for segregation of the Booroola (FecB) variant led to an extensive search for other genetic variants contributing to increased ovulation rate and litter size in prolific sheep breeds and strains. These searches were conducted within prolific flocks and through screens for outliers with exceptional performance in the general population. Segregation for a naturally occurring X-linked mutation was observed in the Inverdale and Hanna sheep strains in New Zealand (Davis et al. 1991, 1994). Heterozygous carriers had increased ovulation rate and twin and triplet births, while homozygous carriers were infertile with primary ovarian failure (Davis et al. 1992). The Inverdale (FecXI) locus was mapped to a region of sheep X chromosome equivalent to human Xp11.2–11.4 (Galloway et al. 2000). This region contained BMP15, encoding bone morphogenetic protein 15 (also known as growth differentiation factor 9B), a member of the transforming growth factor β (TGFβ) superfamily specifically expressed in oocytes. Sequencing BMP15 identified independent point mutations in the coding region of BMP15 in Inverdale and Hanna strains (Galloway et al. 2000). The mutation in the Inverdale strain resulted in a non-conservative amino acid change in a highly conserved region of the protein, and in the Hanna strain introduces a premature stop codon (Galloway et al. 2000).

The Cambridge and Belclare breeds of sheep also exhibited extreme variation in ovulation rate and female sterility due to ovarian hypoplasia, similar to the Inverdale strain (Hanrahan et al. 2004). Studies of inheritance patterns suggested the sterility was consistent with autosomal, rather than X-linked segregation, although two major genes may have been involved. GDF9 (growth differentiation factor 9) was a strong candidate for the autosomal segregation of increased ovulation and sterility since GDF9 is autosomal and closely related to BMP15. Both genes are expressed in the oocyte and play essential roles in female fertility (McGrath et al. 1995; Laitinen et al. 1998). Sequencing of the coding region of GDF9 identified a non-conservative amino acid substitution associated with sterility and increased ovulation rate (Hanrahan et al. 2004). Sequencing of BMP15 in the same flocks also identified novel nucleotide variants in the mature coding region causing a premature stop codon and a non-conservative amino acid substitution both associated with sterility and increased ovulation rate (Hanrahan et al. 2004). The results showed that both BMP15 and GDF9 were essential for folliculogenesis in sheep and complete disruption of the function of either of these members of the TGFβ superfamily disrupted follicle development resulting in ovarian hypoplasia and sterility.

The discoveries of mutations in BMP15, BMPR1B and GDF9 encouraged further searches for mutations in other genes with large effects on ovulation rate and litter size. Progress has been reviewed regularly (Montgomery et al. 2001; McNatty et al. 2005; Scaramuzzi et al. 2011; Vinet et al. 2012; Liu et al. 2014; Monniaux 2016; Garcia-Guerra et al. 2018; Monget et al. 2021). Multiple independent variants have now been identified in both BMP15 and GDF9 in sheep strains around the world with differing estimates for the effect sizes on ovulation rate in heterozygotes (Liu et al. 2014; Garcia-Guerra et al. 2018; Holm et al. 2022). Homozygous carriers for most BMP15 and GDF9 variants are infertile, but there are examples of variants in both genes that increase ovulation rate in both heterozygous and homozygous carriers (Table 1, Fig. 1).

Table 1.Summary of genes with variants of large effect reported to alter ovulation rate (OR) and litter size.

GeneMutationsSpeciesPhenotypeChromosome
HeterozygotesHomozygotesHumanSheepCattle
BMPR1BGln249ArgSheepIncreased ORA Increased OR466
BMP15MultipleSheepIncreased ORIncreased ORXXX
BMP15MultipleSheepIncreased ORInfertilityXXX
GDF9MultipleSheepIncreased ORIncreased OR557
GDF9MultipleSheepIncreased ORInfertility557
B4GALNT2MultipleSheep and goatsIncreased ORIncreased OR171119
LEPRMultipleSheepNo changeDecreased OR113

Multiple different variants have been reported for GDF9, BM15, and beta-1,4-N-acetyl-galactosaminyl transferase 2 (B4GALNT2). The genes BMP15 and GDF9 are listed twice to demonstrate that for some variants, homozygous carriers are fertile with increased ovulation rate while for other variants, homozygous carriers are infertile. There are multiple linked variants at the leptin receptor (LEPR) locus with the causal variant(s) still to be determined. References to publications describing the discovery of specific mutations and reviews of the effects of specific mutations are provided in the text.

A Ovulation rate.
Fig. 1.

Schematic diagram of the hypothalamic-pituitary-ovarian axis with genes implicated in variation in twinning frequency and litter size from both mutation screening and from genome-wide association studies. Created with BioRender.com.


RD24083_F1.gif

In the Lacaune breed in France, variation in litter size was shown to be associated with segregation of a major gene (FecL) (Drouilhet et al. 2013). This locus mapped to sheep chromosome 11. Subsequent fine mapping reduced the map interval to less than 200 kb containing two genes, insulin-like growth factor 2 mRNA binding protein 1 (IGF2BP1) and beta-1,4-N-acetyl-galactosaminyl transferase 2 (B4GALNT2) (Drouilhet et al. 2013). The most likely candidate was B4GALNT2 with evidence for ectopic expression in ovarian follicles of carriers at both the mRNA and protein levels. B4GALNT2 transferase activity was localised in granulosa cells of carriers, and influenced expression of glycosylated proteins including the inhibin alpha and beta subunits in granulosa cell extracts and follicular fluid (Drouilhet et al. 2013). Segregation for the B4GALNT2 locus in the Noire du Velay population was associated with an allelic effect increasing litter size by +0.4 lambs born per ewe lambing (Chantepie et al. 2018). The same B4GALNT2 mutation has also been found in the D’man breed in Morocco, Tunisia, and Algeria, and in other local breeds in Morocco (Ben Jemaa et al. 2019; Hadjazi et al. 2024) suggesting the mutation may have arisen in a common ancestor of breeds in France and North Africa, as seen in the common origin of the FecB mutation in different breeds and strains in China, India, and Australia (Davis et al. 2002; Chong et al. 2022). In the Small Tail Han sheep in China, sequencing of B4GALNT2 identified two mutations in the coding region (Guo et al. 2018) providing support for B4GALNT2 as the candidate gene responsible for the FecL locus (Table 1, Fig. 1). A synonymous mutation in B4GALNT2 has also been reported in Nanjiang Yellow goats that decreases mRNA stability of the B4GALNT2 gene and is associated with growth traits and litter size (Xu et al. 2024).

In New Zealand, further screening for high litter size in commercial flocks led to the establishment of a prolific Davisdale line from a founder ewe with a history of three litters of quadruplets who raised 18 lambs from her last six pregnancies (Juengel et al. 2011). Evidence for a major gene affecting ovulation rate (fecundity Davisdale, FecD) and embryo–fetal survival has been reported for this flock (Juengel et al. 2011; Juengel et al. 2016). Follow-up studies discovered mutations in the coding region of the leptin receptor (LEPR) gene in the Davisdale line that were strongly associated with a delay in attainment of puberty and increased weight and body-condition score at 18 months of age (Haldar et al. 2014). Mutations in LEPR are also associated with reduced ovulation rates (Table 1, Fig. 1) and failure to conceive during the first breeding cycle increasing the number of non-pregnant ewes at mid-pregnancy and lambing (Juengel et al. 2016). Homozygous carriers for the linked LEPR variants had on average, fewer ova at ovulation when compared with either heterozygotes or wild-type contemporaries, suggesting a recessive effect on ovulation rate (Fig. 1) (Juengel et al. 2016). Females with the LEPR mutations and failure to conceive may be failing to express oestrous behaviour rather than failing to ovulate. A single nucleotide polymorphism (SNP) in the coding region of LEPR previously associated with reproductive traits (Haldar et al. 2014) results in an amino acid substitution from proline to serine (p.P1019S) adjacent to a potential phosphorylation site at a conserved serine residue at position 1018 (Macé et al. 2022). Higher levels of fat reserves in ewes carrying the LEPR p.P1019S mutation were observed all along the productive cycle and LEPR genotype explained 5% of the variance in the trait (Macé et al. 2022). The results suggest animals carrying LEPR mutations may provide a new model to better understand how leptin signalling influences body composition and alters important reproductive processes (Juengel et al. 2016). There is evidence for segregation of additional genes affecting ovulation rate and litter size in other breeds and strains (Liu et al. 2014; Garcia-Guerra et al. 2018), but the genes and mutations are still to be identified.

Candidate gene studies

Genetic association between a range of genes and litter size in both sheep and goats have been reported from recent candidate gene studies. Some examples include BMP2 (Imran and Al-Thuwaini 2024a), E2F8 (Zhu et al. 2024), FLT3, NLRP5, and TGIF1 (Chen et al. 2021), FST (Al-Thuwaini et al. 2023), GRM1, GNAQ and HCRTR1 (Zhu et al. 2022), INHA (Bian et al. 2023), NOX4, PDE11A and GHR (Li et al. 2024), PRLR, IGF1, and LEP (El-Shorbagy et al. 2022), PTX3 (Imran and Al-Thuwaini 2024b), SMAD2 (Wijayanti et al. 2023a, 2023b). Overall, there is little overlap in the genes with reported associations with litter size between studies. Sequencing of the INHA locus in Hainan black goats identified variants in exon 1 and exon 2 of this gene. Significant association with litter size was reported for one non-synonymous variant in exon 2 that coded for a change of amino acid sequence at position 316 of the inhibin A protein from Threonine to Proline (Bian et al. 2023). Association between genotypes for the synonymous variant at p.205Tyr in the FST gene and twinning rate has been reported in Awassi sheep (Al-Thuwaini et al. 2023). In common with most other studies, the statistical significance for these reported associations are modest and there was no correction for multiple testing within the studies. In another example, E2F8 genotyping for an insertion/deletion polymorphism in Australian White sheep reported a highly significant association (P = 1.3 × 10−9) with litter size at the fifth parity (Zhu et al. 2024). Significance for association with litter size was driven by a small number of ewes homozygous for the deletion at the later age, and there was either no evidence for association or modest evidence for significant effects at earlier parities.

Replication studies will be essential to judge the significance of these candidate gene studies in sheep and goats in defining novel candidates for functional evaluation and potential marker assisted selection. However, many of these studies have similar characteristics to candidate gene studies in human genetics published before the successful application of large-scale genome-wide association methods. Review of the overlap between results from genome-wide association studies (GWAS) and candidate gene studies reveals that almost no reported associations in the human candidate gene studies were replicated in the GWAS era (Duncan et al. 2019; Montgomery 2020). Too often the candidate gene studies used small samples and failed to adequately account for the multiple testing issues. Corrections for multiple testing must be applied within studies and the data suggest a stringent threshold, more like the threshold for significance in GWAS studies, needs to be applied to candidate gene association studies. Testing SNP by SNP and gene by gene without more stringent correction thresholds in the human studies meant most reported results were false positives (Montgomery 2020). Failure to replicate results highlights the importance of study power and appropriate statistical analysis to prevent publication of false-positive results.

Genome-wide association studies

A case control GWAS strategy and genome sequencing identified a novel mutation (FecXN) upstream of BMP15 in Noire du Velay (NV) breed in France with evidence for reduced expression of this gene in oocytes (Chantepie et al. 2018). The variant increases litter size in both heterozygous and homozygous carriers and is also found in the Blanche du Massif Central and Lacaune breeds. The likely causal variant is located 290 bp upstream of the ATG start site for BMP15 and the variant significantly reduced promoter activity in a luciferase reporter assay (Chantepie et al. 2018). Genome-wide association studies to identify more common variants associated with litter size in sheep and goats report some suggestive evidence for several genome regions (Xu et al. 2018; Gholizadeh and Esmaeili-Fard 2022; Sun et al. 2023). The sample sizes included in these studies were modest and a meta-analysis of the results across different breeds reported only one variant within BMPR1B that was associated with litter size at the genome-wide level of significance level (Table 2) (Gholizadeh and Esmaeili-Fard 2022). More powerful association studies in sheep are likely to discover additional variation associated with litter size.

Table 2.Summary of potential target genes affecting ovulation rate in genome regions identified from genome-wide association studies or segregation of a major gene where the causal mutation has not been identified.

GeneEvidenceSpeciesPhenotypeChromosomeReferences
HumanSheepCattle
FSHRGene testHumanDZ twinning2311 Mbarek et al. (2024)
GNRH1AssociationHumanDZ twinning828 Mbarek et al. (2024)
FSHBAssociationA HumanFSH concentration and DZ twinning111515 Mbarek et al. (2024)
IPO8Gene testB HumanDZ twinning1235 Mbarek et al. (2024)
SMAD3AssociationHumanDZ twinning15710 Mbarek et al. (2024)
ZFPM1AssociationHumanDZ twinning161418 Mbarek et al. (2024)
IGF1AssociationCattleTwinning1235 Garcia-Guerra et al. (2018)
SMAD6SegregationC CattleOvulation rate and expression of SMAD615710 Kamalludin et al. (2018)
BMPR1BAssociationSheepLitter size466 Gholizadeh and Esmaeili-Fard (2022)

Target genes and genomic regions listed in the table include only results declared genome-wide significant in the original publications or with evidence for replication in more than one study.

A Association – evidence for potential target genes from genetic risk factors identified in genome-wide association studies.
B Gene Test – evidence for association in gene-based tests from genome-wide association data.
C Segregation – evidence for segregation of a major gene defining a genomic region of interest but where the causal mutation has not yet been identified.

Twinning genes in cattle

A search for exceptional reproductive performance in cattle provided evidence for a major gene affecting multiple births. Chris Morris identified a cow named Treble that produced three sets of triplets in her lifetime (Morris et al. 2010). A son of Treble (Trio) sired daughters who gave birth to twins or triplets and semen from Trio was used to generate offspring to measure ovulation rates. DNA samples were genotyped for within family linkage analysis providing strong evidence for segregation of a single gene with a large effect on ovulation rate mapped to cattle chromosome 10 (Kirkpatrick and Morris 2015). The region on cattle chromosome 10 includes the genes for SMAD3 and SMAD6 with roles in GDF9 and BMP15 signalling making these genes good candidates for the causal gene(s). Screening for variants in the coding and flanking regions of SMAD3 and SMAD6 did not identify the likely causal mutation(s) suggesting the causal variant is located in a regulatory element or some other gene is responsible and has yet to be identified (Kirkpatrick and Morris 2015). Heterozygous Trio carrier females have an ovulation rate of 3.5 ovulations compared to a single ovulation in non-carriers (García-Guerra et al. 2017) and there is evidence for significant over expression of SMAD6 transcripts in granulosa cells implicating SMAD6 as the gene responsible for the high ovulation rate phenotype in this family (Table 2) (Kamalludin et al. 2018). In carriers of the Trio allele, antral follicle growth and granulosa cell proliferation are decreased before selection of dominant follicles relative to rates in non-carriers due to overexpression of SMAD6 in carriers, allowing selection of more follicles at smaller diameters (Constantino et al. 2023; Domingues et al. 2023). In production systems, some of the disadvantages of multiple births with this genotype may be overcome through follicular ablation to create bilateral twin pregnancies or Trio carriers with frequent production of corpora lutea on both ovaries may be suitable recipients for bilateral embryo transfers (Madureira et al. 2020).

Genetic association studies in prolific cattle herds have also identified genomic regions with risk variants associated with twinning and some candidate regions have been replicated. The bovine chromosome 5 segment associated with twinning containing IGF1 has been replicated in Norwegian and US cattle populations (Garcia-Guerra et al. 2018). Two other regions on bovine chromosome 23 and chromosome 7 show some degree of replication. Those regions contain the steroid 21-hydroxylase (CYP21) gene (chr 23) and anti-Müllerian hormone (AMH) gene (chr 7). The causal relationship between the genetic risk factors and roles for the positional candidate genes in all three regions are yet to be validated (Garcia-Guerra et al. 2018).

Human twinning

Spontaneous birth of two or more offspring in humans includes dizygotic (DZ) or non-identical twins and a significant proportion of monozygotic (MZ) or genetically identical twins. The frequency of DZ twinning, arising from fertilisation of twin ovulations, is influenced by maternal age and by genetic factors as it is observed to run in families and shows striking variation across different populations (Hoekstra et al. 2008; Gajbhiye et al. 2018). DZ twinning rates have risen in many countries over recent decades with a general increase in maternal age and the increasing use of assisted reproductive technology (ART) (Gajbhiye et al. 2018; van Dongen et al. 2021).

In contrast, there is little evidence for genetic effects on MZ twinning as it rarely runs in families and the frequency is similar in different populations (Bulmer 1970; van Dongen et al. 2024). A fascinating recent insight for MZ twins revealed a unique epigenetic signature shared by MZ twins (van Dongen et al. 2021). This stable DNA methylation signature is found in both childhood and adult somatic tissues. MZ twins keep this molecular signature across the lifespan, so this discovery opens up new possibilities for understanding mechanisms of MZ twinning and for retrospective diagnosis of individuals who may have had an identical co-twin that vanished in the early stages of pregnancy (van Dongen et al. 2021). The discovery and implications of this epigenetic signature in MZ twins was reviewed recently (van Dongen et al. 2024) and MZ twins will not be considered further here.

Rare variants in the oocyte growth factor signalling pathway

Spontaneous DZ twinning is influenced by the frequency of twin ovulation, fertilisation, and successful twin pregnancy (Tong and Short 1998). Screening for mutations in the critical genes identified from sheep studies first identified association between a loss-of-function mutation in GDF9 in two sisters with spontaneous DZ twins. The mutation is a four-base pair insertion/deletion variant in exon 1 that alters the reading frame for the protein introducing a stop codon at position 88 (Montgomery et al. 2004). Further analysis of GDF9 in probands from DZ twin families identified two additional insertion/deletion mutations (c.392-393insT, c.1268-1269delAA) and four missense alterations (Palmer et al. 2006). Two of the missense variants (P103S and T121L) were located in the pro-region of GDF9 and two (P374L and R454C) in the mature protein region. The frequencies of individual variants P103S, P374L, and c.1268_1269delAA (frame shift), and the pooled prevalence data for GDF9 variants were significantly higher in mothers of DZ twins (Palmer et al. 2006; Belli and Shimasaki 2018). In contrast, screening BMP15 in mothers of DZ twins identified several mutations and deletion/insertions (Zhao et al. 2008), but no evidence of association. Three variants (P174S, A311T, and R392T) identified were not detected in 1512 controls, but there was no significant evidence these variants were associated with DZ twinning (Zhao et al. 2008).

There is functional evidence that mutations P103S and P374L in GDF9 reduce mature GDF9 expression and in vitro granulosa cell proliferation (Belli and Shimasaki 2018). The results suggest these mutations might decrease GDF9 levels by 50% in heterozygous women carrying these mutations (Belli and Shimasaki 2018). However, the magnitude of effects of the reported variants in GDF9 on increased DZ twinning rates is unknown. Mutations with large effects on ovulation rate that cause substantial increases in twinning frequency in humans may be selected against because of adverse effects on survival of twin pregnancies. Reports on whether twin pregnancies increase lifetime reproductive success in humans are mixed and humans may be better adapted for single pregnancies (Ball and Hill 1999). There is a view that multiple ovulations increase fertility as an ‘insurance’ against failure of fertilisation or embryo loss with birth of DZ twins as a ‘side effect’ (Ball and Hill 1999). Analysis of rare variants and twinning frequency in large population datasets like the UK Biobank may answer some of these questions.

Genome-wide association results

More recently, genome-wide association studies (GWAS) in mothers of DZ twins have been conducted to identify additional genetic variation associated with DZ twinning (Mbarek et al. 2016, 2024; Gordon et al. 2023). The initial GWAS analysed data from 1980 mothers of spontaneous DZ twins and 12,953 controls. An important quality control step was to carefully screen out cases of twins born following the use of artificial reproductive technologies (ART) as we have shown that the phenotypic definition of spontaneous DZ twins is very sensitive to inclusion of even a small proportion of twin pregnancies following ART (Mbarek et al. 2016). The results identified association with DZ twinning for SNPs in an intergenic region flanked by PGBD5 (PiggyBac Transposable Element Derived 5) and COG2 (Component Of Oligomeric Golgi Complex 2) on chromosome 1 and regions close to FSHB (follicle-stimulating hormone beta subunit) on chromosome 11 and SMAD3 (SMAD family member 3) on chromosome 15 (Table 2) (Mbarek et al. 2016). Association for risk alleles close to FSHB and in SMAD3, but not the chromosome 1 locus, were replicated in the Icelandic population in the deCODE database. The risk of having twins in the Icelandic population increased by 18% for each maternal risk allele at the FSHB locus and by 9% for each risk allele for SMAD3 locus (Mbarek et al. 2016). Using a gene-based test that integrates functional information and association results from the GWAS meta-analysis identified nominally significant evidence for BMPR1A (Bone Morphogenetic Protein Receptor Type 1A), BMPR1B (Bone Morphogenetic Protein Receptor Type 1B), IGF1 (Insulin Like Growth Factor 1), FSHB, and FSHR (Follicle Stimulating Hormone Receptor), but only results for FSHB remained significant after correction for multiple testing.

A second GWAS meta-analysis expanded the discovery sample to include 8265 mothers of DZ twins and 26,252 DZ twin individuals with relevant controls of European ancestry from Australia/New Zealand (ANZ), Europe, and the USA (Mbarek et al. 2024). Genome-wide significant results confirmed the previous associations at the FSHB and SMAD3 loci and identified two novel regions near DOCK5 (Dedicator of Cytokinesis 5) on chromosome 8, and near ZFPM1 (Zinc Finger Protein, FOG Family Member 1) on chromosome 16 (Table 2). The lead SNP on chromosome 8 is located in an intron of DOCK5, adjacent to GNRH1 (Gonadotropin releasing hormone 1) and in strong linkage disequilibrium (LD) with SNP rs6185, a coding sequence variant in GNRH1. There is a single haplotype across this region including these two SNPs with two common alleles and the region is associated with DZ twinning, age at menopause, length of the menstrual cycle, and total testosterone levels (Mbarek et al. 2024). It is likely that the risk locus on chromosome 8 plays a role in regulation of GNRH1 since GNRH pulse frequency has an important role regulating FSH and LH synthesis and release from the pituitary gland and higher pulse frequency of FSH is reported in mothers of DZ twins (Lambalk et al. 1998). However, some role for DOCK5 cannot be ruled out as it is expressed in reproductive tissues and differentially expressed across the menstrual cycle in endometrium with high expression in the secretory phase, suggesting it is responsive to sex hormone changes across the cycle (Mortlock et al. 2020).

Gene-based tests implicated FSHR, ZFPM1 (Zinc Finger Protein, FOG Family Member 1), and IPO8 (Importin 8) (Mbarek et al. 2024). FSHR has well-established roles in female reproduction whereas ZFPM1 and IPO8 have not previously been implicated in female fertility. ZFPM1 encodes a transcription regulator and is an essential cofactor forming heterodimers with transcription factors of the GATA family. The lead SNP is correlated with SNPs in the region associated with age at menopause and sex hormone binding globulin (SHBG) concentrations (Ruth et al. 2020; Mbarek et al. 2024), with some evidence of association with FSH concentrations (Chen et al. 2013). Genetic evidence for a role for IPO8 was not strong, but IPO8 is expressed in the ovary and uterus. Our functional studies demonstrated significant evidence that the risk SNP regulates expression of IPO8 and there is a casual relationship between the variant associated with DZ twinning and expression of IPO8. In vivo functional tests in zebrafish for IPO8 validated its essential role in female, but not male, fertility (Mbarek et al. 2024).

Functional studies will be required to identify the causal gene(s) for each region and how risk factors influence DZ twinning. Genetic variants at the FSHB locus are associated with multiple reproductive traits including DZ twinning, menstrual cycle length, age at menarche, endometriosis, and uterine fibroids, and the risk SNPs for these traits form a single haplotype across the region with four common alleles (McGrath et al. 2021). This haplotype is also associated with variation in FSH concentrations (Ruth et al. 2016). To identify links to concentrations of reproductive hormones, SNPs from the regions implicated in DZ twinning were matched with GWAS datasets for five reproductive hormones (FSH, LH, sex hormone binding globulin (SHBG), testosterone (T), and oestradiol (E) (Mbarek et al. 2024). The top risk SNP for FSHB was associated with in vivo concentrations of FSH, LH, SHBG, and T and it is most likely that the risk alleles at this region of chromosome 11 influence DZ twinning and other reproductive traits through effects on reproductive hormone concentrations. However, additional mechanisms may also be involved. The gene immediately proximal to FSHB, ARL14EP (ADP Ribosylation Factor Like GTPase 14 Effector Protein) is highly expressed in ovaries, testis, and uterus (McGrath et al. 2021; Mbarek et al. 2024). The lead SNP for DZ twinning is highly correlated with SNPs located in the transcription start site/enhancer region of ARL14EP that regulate expression of ARL14EP in the testis (GTEx Consortium 2017). There is significant evidence the same causal variant influences both DZ twinning and gene expression of ARL14EP (Mbarek et al. 2024). The role of ARL14EP, and relative importance of genetic regulation by SNPs in this region of chromosome 11 on ARL14EP and FSHB in regulating variation in DZ twinning and other reproductive trats through reproductive hormone concentrations or other mechanisms requires further investigation.

Discussion

Studies in prolific strains of sheep, cattle and goats have provided a valuable catalogue of genetic variants of large effect increasing ovulation rate and litter size. Ruminants have proved valuable models as ovulation rate is regulated in these species, but considerable variation in mean ovulation rate between and within species remains. The discovery of genetic variants in the coding regions of critical genes provides valuable insights into the molecular and cellular pathways that regulate follicle growth, maturation, and regulation of ovulation rate. Functional studies were able to draw on the genetic screening studies discussed, early cloning studies in mice (Roy and Matzuk 2006) and functional studies to understand the roles of key genes in the regulation of follicle dominance and ovulation rate. Multiple variants in some genes affecting different regions of the proteins provide further insights into how specific modifications influence function and help explain species differences. Progress has been reviewed regularly including the workshops on ovarian follicle development in ruminants initiated by Professor Rex Scaramuzzi and held in 1992 (Scaramuzzi et al. 1993), 2008 (Scaramuzzi et al. 2011) and 2020 (Juengel et al. 2021). Each meeting produced a consensus paper on the state of knowledge on follicle development and the regulation of ovulation rate. The first two workshops were attended by Rex Scaramuzzi and Ken McNatty who co-authored the publications together with other attendees.

Mutations in key genes GDF9, BMP15, and BMPR1B from the intra-ovarian signalling pathway demonstrated that the oocyte, and not circulating gonadotrophins, are key drivers in follicle regulation and an important influence on species differences in ovulation rate (Mulsant et al. 2001). The mutations resulting in partial or complete loss of function of these proteins, release inhibitory effects so follicles are ready to ovulate at smaller diameters and more follicles will mature before ovulation to generate sufficient granulosa cells and achieve oestradiol concentrations that exceed the threshold required to induce the LH surge (Fabre et al. 2006). Regulation of ovulation rate is also subject to environmental influences and mutations in LEPR further underline the importance of this pathway in the nutritional regulation of ovulation rate (Juengel et al. 2016, 2021).

It is interesting to observe that most genetic risk factors identified in the recent GWAS studies with mothers of DZ twins link directly to clear candidate genes from hypothalamic-pituitary-ovarian pathways with defined roles in regulating ovulation rate and litter size. The candidate genes are mainly from pathways regulating follicle maturation and selection of dominant follicles rather than exit of follicles from the primordial follicle pool. While the causal variants in each of these regions and altered functional regulation of the relevant candidates remain to be confirmed, this observation stands in stark contrast to results from most GWAS studies, where potential candidate genes in each region are not obvious. It is a testament to the work of Ken McNatty and Rex Scaramuzzi, and of course the many others in the field, that extensive studies of the regulation of ovarian function and control of ovulation rate have characterised the genes and pathways so well.

The genetic discoveries of the many coding variants helped to directly identify key genes and enabled functional studies to join all the dots. Other examples for reproductive traits with good links between genetic risk factors and many likely candidate genes include age at menarche (Day et al. 2017; Kentistou et al. 2024) and age at menopause (Ruth et al. 2021) where critical pathways are also reasonably well understood. The implication is that genetic risk factors for diseases like endometriosis (Rahmioglu et al. 2023) and uterine fibroids (Gallagher et al. 2019), where candidate target genes are not obvious, will identify novel genes and provide important biological insights for these diseases. Known variants of large effect have not been discovered for endometriosis or fibroids. However, we expect that rare coding variants associated with disease risk discovered from the extensive exome sequencing data now available in the UK Biobank and other datasets will help identify key genes that in turn will suggest pathways to better interpret the functional effects of genetic risk factors identified from GWAS studies.

Genetic studies have discovered novel genes that may contribute to variation in ovulation rate and twinning. The most likely candidate for the locus segregating on sheep chromosome 11 is B4GALNT2 with evidence for ectopic expression in the ovarian follicles of carriers at both the mRNA and protein levels (Drouilhet et al. 2013). This ectopic expression of B4GALNT2 was localised in granulosa cells of carriers with downstream effects on glycosylated proteins, including the inhibin alpha and beta subunits suggesting a potential mechanism through modifications of inhibin function.

The recent GWAS for DZ twinning identified association in a region of chromosome 16 near ZFPM1, and implicated both ZFPM1 and IPO8 in gene-based tests, both genes not previously implicated in female fertility (Mbarek et al. 2024). The lead SNP on chromosome 16 is located in a regulatory region in the first intron of ZFPM1. The gene is an essential cofactor which acts by forming heterodimers with transcription factors of the GATA family, GATA1, GATA2, and GATA3. The lead SNP for DZ twinning (rs4584807) is completely correlated (LD r2 = 1) with a SNP in the region with suggestive evidence for effects on FSH concentrations (Chen et al. 2013) and in high correlation (LD r2 = 0.77) with the lead SNP in the region (rs56292801) significantly associated with concentrations of SHBG (Ruth et al. 2020). ZFPM1 is expressed in many tissues including ovaries, testis, and the pituitary gland (GTEx Consortium 2017). The gene is also known as Friend of GATA (FOG)-1 and FOG repression is thought to be an important mechanism for regulating expression of GATA-dependent genes in the gonads of several species (Robert et al. 2002). GATA proteins are expressed in multiple cell lineages of both the testis and ovary and can activate gonadal genes including INHA, and genes involved in steroidogenesis including P450 aromatase. In the testis, ZFMP1 and ZFMP2 are co-expressed with GATA factors in testicular cells in which they differentially repress the promoter activities of several GATA-dependent target genes (Robert et al. 2002). It remains to be determined whether variation associated with DZ twinning in the intron of ZFPM1 exerts its effect through direct regulation and downstream effects of variation in ZFPM1, or perhaps indirectly through genetic effects on hormone regulation including SHBG and possibly FSH.

The gene-based tests for DZ twinning implicated CAPRIN2 which is co-located with Importin 8 (IPO8) on chromosome 12 (Mbarek et al. 2024). Individual SNP association results did not reach genome-wide significance. However, rs10843810 located within an intron of IPO8 and associated with DZ twinning was shown to regulate expression of IPO8 in endometrium suggesting a possible causal relationship. The protein encoded by IPO8 (IMPORTIN8) interacts directly with SMAD3 and is required for TGFβ-activated SMAD2/3 to translocate into the nucleus (Xu et al. 2007; Yao et al. 2008). Functional studies in zebrafish demonstrated an essential role for IPO8 in female, but not male, fertility (Mbarek et al. 2024) suggesting this gene may be another target gene influencing twinning rate.

Summary

Genetic segregation, positional cloning, and association studies have discovered numerous mutations and genetic risk factors that contribute to genetic variation in pathways that regulate ovulation rate and litter size. Notable among the discoveries has been the role of mutations in BMP15, GDF9 and BMPR1B contributing to evidence that the oocyte is a key driver in follicle regulation. The multiple variants in different domains of BMP15 and GDF9 have provided valuable insights into the functional roles of these genes and differential regulation contributing to species differences in ovulation rate. Extensive studies in prolific strains of sheep, cattle and goats have provided a valuable catalogue of genetic variants of large effect increasing ovulation rate and litter size. Genetic association studies in mothers of DZ twins are beginning to identify genetic risk factors with smaller effects. Most genes implicated are from pathways with defined roles in regulation of the ovarian function, in part because these pathways are now well defined. However, some genomic regions suggest regulation of novel genes and the search is continuing for genetic variation affecting ovulation rate and litter size through association studies and segregation of variants of large effect. These studies will continue to improve our understanding of the detailed regulation of ovulation rate and litter size with implications for health and animal production systems.

Data availability

No data were generated for this paper which reviews published data.

Conflicts of interest

The author declares that they have no conflicts of interest.

Declaration of funding

G.W.M. was supported by The National Health and Medical Research Council (NHMRC) Investigator Award GNT1177194.

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