In PCOS, generation of ROS from mononuclear cells and lipid peroxidation products in serum are significantly elevated, and activities of antioxidative enzymes (SOD, CAT, GPx) become reduced, that ultimately may contribute to oxidative stress mediated apoptosis in atretic follicles.
MEL prevents apoptosis by inducing Bcl2 expression and reducing Casp3 activity.
MEL may increase IGF-1 and transform growth factor-beta (TGF-β) production, which are anti-apoptotic.
Thus, normally the increase in follicular MEL concentrations in the growing follicles could be an important factor in avoiding atresia.
Action of melatonin on steroidogenesis
Melatonin is acknowledged for exerting a very relevant role in modulating ovarian functions and oocyte maturation.
MEL treatment may significantly help to maintain LH/FSH balance as well as the level of gonadal androgens to control the development of PCOS via MT1 and MT2 receptor proteins.
MEL is also effective in the regulation of LH receptor gene expression, and gonadotropinreleasing hormone receptor gene expression in human granulosalutein cells via the mitogen-activated protein kinase (MAPK) pathway.
A recent study published in FEB 2018 in the journal Reproductive Sciences showed the beneficial role of Melatonin for women with polycystic ovary syndrome (PCOS).
Melatoninwasadministrated to PCOS patientsata dose of 2mg for 6 months after thorough clinical evaluation and laboratory workup. After 6 months and without any modification of their diet or lifestyle, patients showed a significant:
Decreasein androgen levels (-26%)
Decreasein AMH levels (-30%)
Decreasein LDL cholesterol (-11%)
Decrease in BMI (weight loss) although minor (-3%)
Increase in FSH levels (+28%)
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