Reverse Effects of Nicotinamide Mononucleotide Supplementation on Declining Quality of Oocytes With Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) adversely impacts oocyte quality, underscoring effective interventions as a central focus of research. Our study demonstrates that nicotinamide mononucleotide (NMN) not only restores NAD⁺ homeostasis in oocytes from PCOS mice but also enhances the developmental rate of PCOS oocytes during in vitro maturation (IVM). Transcriptomic analysis and experimental validation suggest that NMN helps reverse the decline in PCOS oocyte quality by mitigating oxidative stress, improving mitochondrial function, and preserving spindle morphology. Mechanistically, we found that NMN supplementation upregulates SIRT1 expression, which responds to fluctuations in NAD⁺ levels through the NAD⁺ salvage pathway regulated by nicotinamide mononucleotide adenylyltransferase (NMNAT). In conclusion, our findings highlight the potential of NMN in improving PCOS oocyte quality, offering valuable insights for clinical PCOS treatment and the advancement of assisted reproductive technology.