Dietary supplementation for female infertility: Recent advances in the nutritional therapy for premature ovarian insufficiency

Advances in cytokine-based herbal medicine against premature ovarian insufficiency: A review

ETHNOPHARMACOLOGICAL RELEVANCE

Premature ovarian insufficiency (POI) refers to a dramatic decrease in the number and/or quality of oocytes in the ovaries before the age of 40 years, and is a key cause of female infertility. The prevalence of POI has been increasing annually and tends to be younger. Researches on the etiology of POI and related pathogenesis are still very limited. Herbal medicine can treat many gynecological diseases. And herbal medicine is effective in reproductive health care such as infertility. In recent years, it has been found that immune modulation by cytokines (CK) can prevent or intervene in POI, and herbal medicine can treat POI by regulating CK to improve ovarian function and fertility.

AIM OF THE STUDY

This review presents an overview of the molecular mechanisms of regulation of POI related CK, and reports the therapeutic effect of herbal medicine on POI including herbal medicine formulas, single herbal medicine, herbal medicine active components and acupuncture. This review provides theoretical support for clinical prevention and treatment of POI, and provides new ideas for researches on herbal medicine treatment of POI.

MATERIALS AND METHODS

We performed a collection of relevant scientific articles from different scientific databases regarding the therapeutic effect of herbal medicine on POI by regulating CK, including PubMed, Web of Science, Wanfang Database, CNKI and other publication resources. The search terms used in this review include, 'premature ovarian insufficiency', 'premature ovarian failure (POF)', 'infertility', 'herbal medicine', 'acupuncture', 'cytokine', 'interleukin (IL)', 'tumor necrosis factor-α (TNF-α)', 'interferon-γ (IFN-γ)', 'transforming growth factor-β (TGF-β)', 'vascular endothelial growth factor (VEGF)', 'immune' and 'inflammation'. This review summarized and analyzed the therapeutic effect of herbal medicine according to the existing experimental and clinical researches.

RESULTS

The results showed that herbal medicine treats POI through CK (including ILs, TNF-α, INF-γ, VEGF, TGF-β and others) and related signaling pathways, which regulates reproductive hormones disorder, reduces ovarian inflammatory damage, oxidative stress, apoptosis and follicular atresia, improves ovarian pathological damage and ovarian reserve function.

CONCLUSIONS

This review enriches the theory of POI treatments based on herbal medicine by regulating CK. The specific mechanisms of action and clinical researches on the treatment of POI by herbal medicine should be strengthened in order to promote the application of herbal medicine in the clinic and provide new ideas and better choices for the treatment of POI.

[Gly14]-humanin exerts a protective effect against D-galactose-induced primary ovarian insufficiency in mice

RESEARCH QUESTION

Is there a protective effect of the humanin derivative [Gly14]-humanin (HNG) on a D-gal-induced mouse model of primary ovarian insufficiency (POI), and what is the underlying mechanism?

DESIGN

D-gal (200 mg/kg/day) was injected subcutaneously for 6 weeks to induce the mouse POI model. Mice treated with HNG were injected intraperitoneally with different concentrations for 6 weeks. Ovarian morphology, function, levels of sex hormones and states of oxidative stress in the ovary and body were evaluated.

RESULTS

Compared with the D-gal group, 10 mg/kg HNG improved the abnormal ovarian morphology and oestrous cycle (P = 0.0036), increased the number of ovarian follicles (P = 0.0016) and litters (P = 0.0127), and increased the levels of oestrogen (P = 0.0043) and AMH (P = 0.0147). Antioxidant indicators in the ovaries and serum of mice, including total antioxidant capacity (P = 0.0004 and P = 0.0032, respectively), catalase (P = 0.0173 and P = 0.0103, respectively) and glutathione (both P < 0.0001) were significantly increased. The oxidation indicator malondialdehyde decreased significantly (all P < 0.01). Apoptosis of ovarian granulosa cells was significantly reduced (P = 0.0140) as was the expression of senescence-related proteins p53, p21 and p16 (all P < 0.01). The level of autophagy in ovarian tissue of mice treated with high increased (significantly increased LC3 protein [P < 0.0001] and significantly reduced p62 protein [P = 0.0007]).

CONCLUSIONS

HNG inhibited D-gal-induced oxidative stress, apoptosis and ovarian damage, promoting ovarian autophagy. HNG may be a potential prophylactic agent against POI.

The Role of Lifestyle and Dietary Factors in the Development of Premature Ovarian Insufficiency

Premature ovarian insufficiency (POI) is a condition that arises from dysfunction or early depletion of the ovarian follicle pool accompanied by an earlier-than-normal loss of fertility in young women. Oxidative stress has been suggested as an important factor in the decline of fertility in women and POI. In this review, we discuss the mechanisms of oxidative stress implicated in ovarian ageing and dysfunction in relation to POI, in particular mitochondrial dysfunction, apoptosis and inflammation. Genetic defects, autoimmunity and chemotherapy, are some of the reviewed hallmarks of POI that can lead to increased oxidative stress. Additionally, we highlight lifestyle factors, including diet, low energy availability and BMI, that can increase the risk of POI. The final section of this review discusses dietary factors associated with POI, including consumption of oily fish, mitochondria nutrient therapy, melatonin, dairy and vitamins that can be targeted as potential interventions, especially for at-risk women and in combination with personalised nutrition. Understanding the impact of lifestyle and its implications for POI and oxidative stress holds great promise in reducing the burden of this condition.

Therapeutic prospect on umbilical cord mesenchymal stem cells in animal model with primary ovarian insufficiency: a meta-analysis

Background

Primary ovarian insufficiency (POI) leads to not only infertile but several adverse health events to women. Traditional treatment methods have their own set of limitations and drawbacks that vary in degree. Application of human umbilical cord mesenchymal stem cell (hUCMSC) is a promising strategy for POI. However, there is a lack of literatures on application of hUCMSC in human. Animal experimental model, however, can reflect the potential effectiveness of this employment. This study aimed to evaluate the curative effect of hUCMSC on animals with POI on a larger scale.

Methods

To gather data, Pubmed, Embase, and Cochrane Library were searched for studies published up to April 2022. Various indices, including the animals' estrous cycle, serum sex hormone levels, and follicle number in the ovary, were compared between the experimental group and those with Premature Ovarian Insufficiency (POI).

Results

The administration of human umbilical cord-derived mesenchymal stem cells (hUCMSC) has been shown to significantly improve the estrous cycle (RR: 3.32, 95% CI: [1.80, 6.12], I² = 0%, P = 0.0001), but robustly decrease its length (SMD: -1.97, 95% CI: [-2.58, -1.36], I² = 0%, P < 0.00001). It can also strikingly increase levels of serum estradiol (SMD: 5.34, 95% CI: [3.11, 7.57], I² = 93%, P < 0.00001) and anti-müllerian hormone (SMD: 1.92, 95% CI: [0.60, 3.25], I² = 68%, P = 0.004). Besides, it lowers levels of serum follicle-stimulating hormone (SMD: -3.02, 95% CI: [-4.88, -1.16], I² = 93%, P = 0.001) and luteinising hormone (SMD: -2.22, 95% CI: [-3.67, -0.76], I² = 78%, P = 0.003), and thus collectively promotes folliculogenesis (SMD: 4.90, 95% CI: [3.92, 5.88], I² = 0%, P < 0.00001).

Conclusions

Based on the presented findings, it is concluded that the administration of hUCMSC in animal models with POI can result in significant improvements in several key indicators, including estrous cycle recovery, hormone level modulation, and promotion of folliculogenesis. These positive outcomes suggest that hUCMSC may have potential as a treatment for POI in humans. However, further research is needed to establish the safety and efficacy of hUCMSC in humans before their clinical application.

Systematic review registration

https://inplasy.com/inplasy-2023-5-0075/, identifier: INPLASY202350075.