Mechanisms and Application Status of Melatonin in Protecting Ovarian Reserve Function

doi:10.12280/gjszjk.20250620

Abstract

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

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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