Yougui Pills Alleviates Diminished Ovarian Reserve Through Regulating Oxidative Stress and Apoptosis in Rats

Objective Yougui pills (YGP) have been used clinically to treat diminished ovarian reserve (DOR), but, whether YGP could have a palliative effect in the DOR rat model and the underlying mechanisms have not been clearly elucidated. This study aims to investigate the therapeutic effect and potential mechanisms of YGP in rats with cortisol-induced DOR. Methods The cortisol-induced DOR model was used to investigate the protective effects and mechanism of YGP on DOR. The DOR model was established by intramuscular injection of 25 mg/kg cortisol for 28 consecutive days. Meanwhile, the rats were weighed and administered intragastrically YGP or progynova. To evaluate the mitigating effect of YGP on DOR, pharmacodynamic indicators were assessed including body weight, estrous cycle, H&E staining, and serum levels of AMH, FSH, LH, and cortisol. Oxidative stress (OS) and apoptosis pathways were further validated using Western blotting analysis. Result YGP significantly ameliorated the symptoms of DOR. Administration of YGP improved the ovarian index, estrous cycle, and body weight. After treatment with YGP, cortisol, FSH, and LH levels declined and AMH levels elevated. YGP increased the number of primary, secondary, and antral follicles, but decreased the number of atretic follicles. Mechanically, YGPtreated cortisol-induced DOR via the Keap1/Nrf2 signaling pathway which regulates OS. YGP also reversed the aberrant expression of apoptosis-related proteins Caspase-3, Bcl-2, and Bax. Conclusion YGP could reduce ovarian OS and apoptosis in cortisol-induced rats via regulating the Keap1/Nrf2 signaling pathway, thereby enhancing ovarian reserve function.