褪黑素保护卵巢储备功能的机制及应用现状

doi:10.12280/gjszjk.20250620

摘要/Abstract

摘要：

褪黑素（melatonin）是一种主要由松果体合成的吲哚胺类激素，具有调节睡眠、抗氧化、清除自由基等作用。近年研究发现，褪黑素可通过多种机制改善卵巢储备功能并延缓卵巢衰老。氧化应激可促进卵泡闭锁，是导致卵巢储备功能下降的重要病理机制。褪黑素可通过高效清除自由基发挥抗氧化应激效应，且具有线粒体靶向性；可抑制颗粒细胞凋亡和铁死亡，调节自噬，促进卵泡发育；可调控包括核转录因子红系2相关因子2/抗氧化响应元件（nuclear factor-erythroid 2-related factor 2/antioxidant response element，Nrf2/ARE）、磷脂酰肌醇3激酶/蛋白激酶B （phosphatidylinositol 3-kinase/protein kinase B，PI3K/Akt）、沉默信息调节因子1（silent information regulator 1，SIRT1）在内的多条信号通路，发挥卵巢保护作用。研究证实，褪黑素在减轻放化疗所致的卵巢毒性及生育力保护中具有潜在应用前景。临床研究表明，褪黑素在辅助生殖技术及卵巢储备功能减退患者中的应用已展现出潜在价值，但其疗效存在异质性，缺乏高质量循证医学证据。未来进一步的研究应明确其疗效并优化用药策略，从而为褪黑素在卵巢保护领域的应用提供依据。

关键词: 褪黑激素, 氧化性应激, 卵巢储备功能, 生殖技术, 辅助, 生育力

Abstract:

Melatonin is an indoleamine hormone primarily synthesized by the pineal gland, known for its roles in regulating sleep, exerting antioxidant effects, and scavenging free radicals. Recent studies have found that melatonin can improve ovarian reserve function and delay ovarian aging through multiple mechanisms. Oxidative stress promotes follicular atresia and serves as a key pathological mechanism leading to diminished ovarian reserve. Melatonin can effectively counteract oxidative stress by scavenging free radicals, with a particular mitochondrial targeting capacity, can inhibit granulosa cell apoptosis and ferroptosis, and regulate autophagy to promote follicular development. Melatonin can modulate multiple signaling pathways including nuclear factor-erythroid 2-related factor 2/antioxidant response element (Nrf2/ARE), phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), and silent information regulator 1 (SIRT1) to exert the ovarian protection. For example, melatonin has shown the promising application in mitigating the ovarian toxicity caused by radiotherapy or chemotherapy, and in fertility preservation. Clinical studies have demonstrated the potential value of melatonin in assisted reproductive technology, especially in patients with diminished ovarian reserve. However, the efficacy shows heterogeneity and lacks high-quality evidence-based medical support. Further studies are needed to clarify its therapeutic effects and optimize treatment strategies, thereby providing a foundation for the application of melatonin in the field of ovarian protection.

Key words: Melatonin, Oxidative stress, Ovarian reserve, Reproductive techniques, assisted, Fertility

陈文俊, 徐献丽, 张艺超. 褪黑素保护卵巢储备功能的机制及应用现状[J]. 国际生殖健康/计划生育杂志, 2026, 45(3): 224-229.

CHEN Wen-jun, XU Xian-li, ZHANG Yi-chao. Mechanisms and Application Status of Melatonin in Protecting Ovarian Reserve Function[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(3): 224-229.

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