Melatonin alleviates cyclophosphamide-induced ovarian toxicity in mice.

Purpose: Anticancer drugs like cyclophosphamide (CTX) cause severe ovarian damage, often leading to infertility, while current fertility preservation methods are invasive and costly. This study investigates whether melatonin (MEL) can protect ovarian function in a CTX-induced premature ovarian failure (POF) mouse model, offering a potential noninvasive and cost-effective fertoprotective approach.

Methods: A CTX-induced POF mouse model was used to assess MEL's protective effects. Ovarian function was evaluated by analyzing follicle counts, ovarian weight, serum hormone levels, apoptosis markers, histopathological changes, vascular integrity, and antioxidant defences.

Results: MEL coadministration increased the proportion of primary and antral follicles (p < 0.01 and p < 0.05) while reducing atretic follicles (p < 0.05). MEL preserved ovarian weight, maintained primordial follicle counts, and prevented CTX-induced hormone level reductions. MEL also enhanced AMH-positive follicle percentage, reduced apoptosis, and mitigated vascular injury, fibrosis, and blood vessel hyalinization (p < 0.05). Furthermore, MEL restored uterine tissue architecture, improved vascular health by recruiting pericytes and smooth muscle cells (p < 0.05), and enhanced antioxidant defenses through increased expression of superoxide dismutase 1 (SOD1) (p < 0.05).

Conclusion: MEL effectively preserves ovarian function in a CTX-induced POF model by protecting follicular development, hormonal balance, vascular integrity, and antioxidant defenses. These findings highlight MEL as a promising, noninvasive, and cost-effective strategy for fertility preservation in female cancer patients undergoing chemotherapy.