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12 pages, 3056 KB  
Article
Development of Highly Sensitive and Specific Monoclonal Antibodies Against Glypican-1 Using the Cell-Based Immunization and Screening Technology
by Haruto Yamamoto, Hiroyuki Suzuki, Tomohiro Tanaka, Mika K. Kaneko and Yukinari Kato
Int. J. Transl. Med. 2026, 6(2), 18; https://doi.org/10.3390/ijtm6020018 (registering DOI) - 25 Apr 2026
Abstract
Background/Objectives: Glypican-1 (GPC1) is a heparan sulfate proteoglycan that plays a critical role in regulating various signaling pathways and tumor development. Overexpression of GPC1 promotes tumor cell proliferation and invasiveness, and is associated with poor clinical outcomes. Therefore, anti-GPC1 monoclonal antibodies (mAbs) have [...] Read more.
Background/Objectives: Glypican-1 (GPC1) is a heparan sulfate proteoglycan that plays a critical role in regulating various signaling pathways and tumor development. Overexpression of GPC1 promotes tumor cell proliferation and invasiveness, and is associated with poor clinical outcomes. Therefore, anti-GPC1 monoclonal antibodies (mAbs) have been developed in various modalities for tumor therapy. Methods: We developed novel anti-GPC1 mAbs using a flow cytometry-based high-throughput screening approach, the Cell-Based Immunization and Screening (CBIS) method. Results: A clone G1Mab-28 (IgG1, κ) reacted with GPC1-overexpressed Chinese hamster ovary-K1 (CHO/GPC1), but not parental CHO-K1, in flow cytometry. Furthermore, G1Mab-28 recognizes the endogenous GPC1-expressing human esophageal squamous cell carcinoma KYSE770 cell line. Furthermore, G1Mab-28 specifically recognized only CHO/GPC1, but not the other GPC family-overexpressed CHO-K1. The dissociation constant values of G1Mab-28 for CHO/GPC1 and KYSE770 were determined to be 3.3 × 10−8 M and 4.6 × 10−9 M, respectively. Moreover, G1Mab-28 is suitable for Western blotting and immunohistochemistry. Conclusions: G1Mab-28, established by the CBIS method, is versatile for basic research and is expected to contribute to antibody-based tumor therapy. Full article
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29 pages, 1933 KB  
Article
Molecular Docking and Pharmacokinetic Profiling of GC-MS-Identified Phytochemicals from Peganum harmala-Derived Essential Oil: In Silico Assessment of Binding Affinity Toward PCOS-Related Targets
by Waad A. Al-Otaibi and Sahar M. AlMotwaa
Appl. Sci. 2026, 16(9), 4214; https://doi.org/10.3390/app16094214 (registering DOI) - 25 Apr 2026
Abstract
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by hyperandrogenism, insulin resistance, and ovarian dysfunction. Current therapies are often associated with adverse effects, highlighting the need for safer therapeutic alternatives. Peganum harmala (P. harmala), [...] Read more.
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by hyperandrogenism, insulin resistance, and ovarian dysfunction. Current therapies are often associated with adverse effects, highlighting the need for safer therapeutic alternatives. Peganum harmala (P. harmala), a medicinal plant rich in bioactive metabolites, was investigated through in silico approaches to identify compounds with predicted binding affinity for the androgen receptor (AR), steroid 17α-hydroxylase/17,20-lyase (CYP17A1), and glycogen synthase kinase-3 beta (GSK-3β). GC-MS analysis of P. harmala leaf essential oil collected in Riyadh, Saudi Arabia, identified 109 compounds, with terpenoids as the dominant class (21.89%). The major constituents were cis-chrysanthenyl acetate (3.48%), cis-β-damascenone (3.06%), farnesylacetone (1.44%), β-calacorene (1.36%), dihydroedulan II (1.04%), and trans-calamenene (0.46%). In silico ADMET evaluation indicated that most compounds complied with Lipinski’s rule of five and showed favorable predicted pharmacokinetic properties. Safety profiling suggested an overall acceptable toxicity profile, with minimal predicted CYP450 inhibition, except for L11, which showed broader inhibitory potential. Molecular docking showed that L15 (trans-calamenene), L14 (dihydroedulan II), L6 (β-calacorene), L3 (farnesylacetone), and L8 exhibited higher predicted binding affinity toward the androgen receptor; L3, L10 (cis-β-damascenone), and L16 (cis-chrysanthenyl acetate) interacted with CYP17A1, while L3, L9, and L6 exhibited higher affinity toward GSK-3β. Overall, these findings provide hypothesis-generating in silico predictions of ligand–target binding affinities and drug-likeness profiles. These computational findings highlight the importance of future experimental investigations to substantiate the biological activity, pharmacokinetic behavior, and safety profile of P. harmala constituents. Full article
(This article belongs to the Section Chemical and Molecular Sciences)
14 pages, 8790 KB  
Case Report
A Novel Hybrid Laparoscopic–Extracorporeal Technique for Fertility-Preserving Management of Large Benign Ovarian Cysts: A Case Report
by Sofia Makrydima and Charalampos Milionis
Reports 2026, 9(2), 131; https://doi.org/10.3390/reports9020131 (registering DOI) - 25 Apr 2026
Abstract
Background and Clinical Significance: The management of large benign ovarian cysts in women of reproductive age requires balancing minimally invasive surgery with oncologic safety and preservation of ovarian function. Laparoscopic cystectomy for large cysts is technically challenging and carries an increased risk [...] Read more.
Background and Clinical Significance: The management of large benign ovarian cysts in women of reproductive age requires balancing minimally invasive surgery with oncologic safety and preservation of ovarian function. Laparoscopic cystectomy for large cysts is technically challenging and carries an increased risk of intraoperative rupture and spillage; Case Presentation: We describe a novel hybrid laparoscopic–extracorporeal technique in which controlled cyst decompression is performed using a balloon-tipped trocar through a suprapubic port under direct laparoscopic visualization. The ovary is then carefully mobilized and exteriorized through the same incision, allowing extracorporeal cystectomy and ovarian reconstruction before returning the adnexa to the abdominal cavity. This approach was applied in a series of six patients with large benign-appearing ovarian cysts, including one 42-year-old patient with an 18 cm multilocular mature cystic teratoma. There were no intraoperative or postoperative complications, no conversions to laparotomy, and all patients were discharged on postoperative day 1. Follow-up at six weeks and subsequent imaging at nine months demonstrated preserved ovarian architecture, normal menstrual function, and high patient satisfaction; Conclusions: The hybrid laparoscopic–extracorporeal approach appears feasible and may offer a safe surgical option in carefully selected patients, allowing fertility preservation while minimizing the risk of spillage. Further studies are needed to evaluate reproducibility, oncologic safety, and long-term reproductive outcomes. Full article
(This article belongs to the Section Obstetrics/Gynaecology)
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12 pages, 1231 KB  
Article
Methodological Evaluation of a P2C-Based ReMOT CRISPR/Cas9 System in Aedes aegypti
by Xiaohui Liu, Wenhao Wang, Xiaoxue Xie, Haotian Yu and Chunxiao Li
Insects 2026, 17(5), 451; https://doi.org/10.3390/insects17050451 (registering DOI) - 24 Apr 2026
Abstract
Mosquito-borne infectious diseases remain a major challenge to public health, highlighting the need for efficient and accessible gene editing approaches. Receptor-mediated ovary transduction of cargo (ReMOT) offers an alternative to embryonic microinjection, in which P2C, an ovary-targeting peptide, enables ovarian delivery of the [...] Read more.
Mosquito-borne infectious diseases remain a major challenge to public health, highlighting the need for efficient and accessible gene editing approaches. Receptor-mediated ovary transduction of cargo (ReMOT) offers an alternative to embryonic microinjection, in which P2C, an ovary-targeting peptide, enables ovarian delivery of the editing components. However, key design parameters and operational boundaries of the P2C-based ReMOT system have not been clearly defined. Here, we performed a methodological evaluation of the P2C-mediated ReMOT CRISPR/Cas9 system in Aedes aegypti. Cas9-P2C fusion proteins with different configurations were constructed and assessed through ovarian targeting assays, in vitro cleavage analyses, and in vivo gene editing experiments. Our results show that full-length Cas9-P2C fusion proteins exhibit nuclease activity and enable effective ovarian delivery. In contrast, linear truncation of the P2C peptide markedly reduced ovarian targeting, indicating a dependence on structural integrity. Using this delivery strategy, we generated kynurenine monooxygenase (KMO) edited mosquitoes, demonstrating feasibility under the conditions tested. In addition, protein injection was also associated with reduced reproductive performance, providing physiological reference for ReMOT applications. Overall, this study defines the key design parameters and operational boundaries of the P2C-based ReMOT system, providing methodological guidance for its application and optimization in future mosquito genetic studies. Full article
(This article belongs to the Section Medical and Livestock Entomology)
17 pages, 3346 KB  
Article
Transport Time Does Not Substantially Alter RNA Expression in Human Ovarian Tissue After Standardized Slow-Freezing for Fertility Preservation
by Iwona Scheliga, Jana Bender-Liebenthron, Jan-Steffen Kruessel, Alexandra Knebel, Dunja M. Baston-Buest and Alexandra P. Bielfeld
J. Clin. Med. 2026, 15(9), 3260; https://doi.org/10.3390/jcm15093260 - 24 Apr 2026
Abstract
Background: Fertility preservation aims to maintain reproductive potential in patients undergoing potentially gonadotoxic treatments, increasingly relying on centralized cryobanks requiring ovarian tissue transport. Ovarian tissue cryopreservation is a widely implemented, evidence-based procedure for young women (age 18–35) with a regular ovarian reserve. The [...] Read more.
Background: Fertility preservation aims to maintain reproductive potential in patients undergoing potentially gonadotoxic treatments, increasingly relying on centralized cryobanks requiring ovarian tissue transport. Ovarian tissue cryopreservation is a widely implemented, evidence-based procedure for young women (age 18–35) with a regular ovarian reserve. The ovaries of patients are typically transported overnight to a centralized cryobank for freezing and storage, using a certified hypothermic organ preservation solution such as histidine-tryptophan-ketoglutarate (HTK) at 4–8 °C. The molecular effects of transport on ovarian tissue remain unclear. Methods: In this prospective study of 36 breast cancer patients, we compared whole-transcriptome RNA (RNA-seq) expression in 18 frozen–thawed ovarian biopsies after overnight hypothermic transport followed by slow-freezing versus 18 direct slow-freezing within ≤2 h under FertiPROTEKT-standard conditions. Results: The RNA-seq analysis identified 6 significantly upregulated genes (Bonferroni < 0.05, fold change > 1.5), including histone H2B and mitochondrial NADH dehydrogenase subunit 6 (MT-ND6). The small number of differentially expressed genes suggests only limited transcriptional changes between the two transport conditions. H2B upregulation was confirmed by qPCR, while MT-ND6 showed only moderate levels in RNA-seq but remained stable in qPCR. Immunohistochemical analysis confirmed protein presence and localization in formalin-fixed tissue from four samples, constituting, to our knowledge, the first report of MT-ND6 protein expression in human ovarian tissue. Conclusions: Overall, these results are consistent with subtle changes in chromatin organization and mitochondrial energy metabolism. Since RNA-seq revealed only modest differences in gene expression, with no appreciable up- or downregulation of apoptosis- or damage-related genes after ≤24 h, this indicates tissue stability under the studied combined conditions (transport + cryopreservation). These findings are consistent with the feasibility of the workflow under the studied conditions of centralized ovarian tissue cryobanking combined with overnight transportation and hypothermic HTK solution. Full article
(This article belongs to the Special Issue Advances in Fertility Preservation)
17 pages, 3054 KB  
Article
Biomimetic Fibrin Matrix Modulates Early Human Follicular Growth Dynamics in a Bioengineered Artificial Ovary Derived from Cryopreserved Tissue: In Vitro Morphometric Assessment
by Mengyang Cao, Plamen Todorov, Cheng Pei, Gohar Rahimi, Christine Skala and Volodimir Isachenko
Int. J. Mol. Sci. 2026, 27(9), 3799; https://doi.org/10.3390/ijms27093799 - 24 Apr 2026
Abstract
Ovarian tissue cryopreservation is the primary fertility preservation strategy for prepubertal girls and patients requiring urgent gonadotoxic therapy. However, the risk of reintroducing malignant cells has prompted the development of safer alternatives, including follicle isolation followed by three-dimensional scaffold encapsulation for transplantation. Fibrin [...] Read more.
Ovarian tissue cryopreservation is the primary fertility preservation strategy for prepubertal girls and patients requiring urgent gonadotoxic therapy. However, the risk of reintroducing malignant cells has prompted the development of safer alternatives, including follicle isolation followed by three-dimensional scaffold encapsulation for transplantation. Fibrin is a promising biomaterial for bioengineered ovary construction, although its ability to support early human follicle maintenance remains unclear. Follicles isolated from cryopreserved ovarian tissues of six patients were encapsulated within fibrin scaffolds of graded concentrations (high, medium, low). After 7 days of in vitro culture, follicle survival and diameter change were quantified. A total of 282 follicles (45.4 ± 10.1 µm) were embedded into fibrin scaffolds. After culture, 237 viable follicles were detected, yielding an overall survival of 84%. Follicle diameter increased to 58.8 ± 12.0 µm. Follicle survival rates were comparable across groups, while mean follicle diameter was 56.3 ± 12.5 µm (high), 61.9 ± 13.4 µm (medium), and 57.4 ± 9.3 µm (low). Follicles cultured in medium-concentration fibrin demonstrated significantly larger diameters compared with both high and low groups (p < 0.05), with no difference between high and low groups. Fibrin-based bioprosthetic ovary scaffolds support short-term in vitro maintenance of isolated human follicles, preserving spherical morphology and granulosa cell layer integrity. Medium-concentration fibrin was associated with greater follicle diameter expansion compared with higher and lower concentrations, indicating that scaffold composition influences early morphometric changes during in vitro follicle culture. Full article
(This article belongs to the Section Molecular Biology)
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30 pages, 1231 KB  
Review
The Impact of Congenital Anomalies of the Male and Female Reproductive Organs on Infertility and Recurrent Pregnancy Loss: A Review
by Bojana Petrovic, Sanja Kostic, Ivana Milan Jovanovic, Milica Petronijevic, Milos Petronijevic, Igor Hudic and Svetlana Vrzic Petronijevic
Medicina 2026, 62(5), 812; https://doi.org/10.3390/medicina62050812 - 24 Apr 2026
Abstract
Congenital anomalies of the reproductive system represent a heterogeneous group of structural and functional abnormalities affecting both male and female genital organs. These anomalies typically arise during embryogenesis and may remain asymptomatic until they are incidentally identified during evaluation for infertility, recurrent pregnancy [...] Read more.
Congenital anomalies of the reproductive system represent a heterogeneous group of structural and functional abnormalities affecting both male and female genital organs. These anomalies typically arise during embryogenesis and may remain asymptomatic until they are incidentally identified during evaluation for infertility, recurrent pregnancy loss, or disorders of sexual development. In females, abnormalities include Müllerian duct anomalies and congenital malformations of the uterus, cervix, vagina, and ovaries, such as Mayer–Rokitansky–Küster–Hauser syndrome, septate, unicornuate, bicornuate, and didelphys uteri, and ovarian agenesis and undescended ovaries. In males, congenital conditions such as anorchia, cryptorchidism, hypospadias, ejaculatory duct obstruction, and ejaculatory dysfunction may be associated with impaired spermatogenesis and reduced fertility. Early recognition of these conditions may facilitate timely clinical evaluation and individualized management, which can include surgical correction, hormonal therapy, and reproductive counseling. When appropriate, early diagnosis may support multidisciplinary care, with the aim of optimizing sexual development, preserving reproductive potential, and reducing long-term morbidity associated with congenital anomalies. However, the clinical impact of early detection varies depending on the type and severity of the anomaly. A systematic and multidisciplinary approach may contribute to improved reproductive outcomes and better overall reproductive health in affected individuals. Further research is needed to better define the optimal timing and clinical utility of systematic evaluation strategies in this patient population. Full article
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28 pages, 2229 KB  
Review
Modern Polycystic Ovary Syndrome (PCOS) Management: Intelligent Drug Delivery and Metabolic Reprogramming for Ovarian Restoration and Fertility Optimization
by Abdel Halim Harrath, Maroua Jalouli, Mohammed Al-Zharani and Md Ataur Rahman
Biomolecules 2026, 16(5), 626; https://doi.org/10.3390/biom16050626 - 23 Apr 2026
Viewed by 311
Abstract
Polycystic ovarian syndrome (PCOS) is a complex endocrine and metabolic disorder that affects reproductive health, metabolic function, and long-term cardiovascular health in women of reproductive age. The syndrome is characterized by hyperandrogenism, chronic anovulation, insulin resistance, oxidative stress, and ovarian microenvironment remodeling. While [...] Read more.
Polycystic ovarian syndrome (PCOS) is a complex endocrine and metabolic disorder that affects reproductive health, metabolic function, and long-term cardiovascular health in women of reproductive age. The syndrome is characterized by hyperandrogenism, chronic anovulation, insulin resistance, oxidative stress, and ovarian microenvironment remodeling. While current treatments focus on symptom relief through hormone regulation, insulin sensitizers, or ovulation induction, there is a need to target the underlying molecular and cellular processes that drive disease progression and infertility. Breakthroughs in reproductive and metabolic medicine have led to the development of next-generation therapeutics for PCOS that aim to restore ovarian function at the molecular level. Nanoparticle- and nanofiber-based drug delivery systems offer targeted delivery to the ovaries, improved bioavailability, and controlled release of insulin sensitizers, antioxidants, and anti-androgens. Metabolic reprogramming strategies that target insulin resistance, mitochondrial dysfunction, and autophagy have emerged as potential disease-modifying interventions. In addition, AI-enabled precision medicine approaches are reshaping PCOS management through phenotype-based classification, predictive modeling, and personalized fertility optimization. In this review, we highlight recent advancements in understanding the molecular pathophysiology of PCOS and introduce novel therapeutics that harness intelligent drug delivery, ovarian microenvironment restoration, and AI-based interventions. We discuss the potential of these innovative strategies to update PCOS management options for long-term ovarian restoration and fertility. Full article
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19 pages, 1549 KB  
Review
GLP-1 Receptor Agonists, Fertility Restoration, and Reproductive Safety in Women of Reproductive Age: A Narrative Review
by Malak Moones Abedi, Mohamedanas Mohamedfaruk Patni, Arshiya Nasreen Bint Shajahan, Rajani Dube, Liyan Khadeeja, Ibrahim Alabid, Ahmad Kharoufeh, Subhranshu Sekhar Kar, Biji Thomas George, Shadha Nasser Bahutair and Thilakavathy Pandurangan
J. Clin. Med. 2026, 15(9), 3204; https://doi.org/10.3390/jcm15093204 - 22 Apr 2026
Viewed by 257
Abstract
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for the management of obesity and type 2 diabetes, particularly among women of reproductive age. Emerging evidence suggests potential effects on ovulation, fertility, and pregnancy outcomes. This narrative review aims to synthesize current evidence [...] Read more.
Background/Objectives: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for the management of obesity and type 2 diabetes, particularly among women of reproductive age. Emerging evidence suggests potential effects on ovulation, fertility, and pregnancy outcomes. This narrative review aims to synthesize current evidence on the reproductive safety of GLP-1RAs, with a focus on their implications for conception, unintended pregnancy, and maternal–fetal outcomes. Methods: A narrative literature review was conducted using PubMed and relevant bibliographic sources to identify studies published between 2020 and 2025. The search included clinical trials, observational studies, registry data, case reports, and selected preclinical evidence. Studies addressing reproductive outcomes, including ovulation, fertility, pregnancy exposure, and fetal safety, were included. Evidence was synthesized descriptively in accordance with recommended approaches for narrative reviews. Results: Available evidence indicates that GLP-1RAs may improve ovulatory function and menstrual regularity, particularly in women with obesity or polycystic ovary syndrome, potentially increasing the likelihood of conception. However, human data on pregnancy exposure remain limited. While current evidence does not consistently demonstrate a strong teratogenic signal, findings are based on small samples and heterogeneous study designs. Concerns persist regarding unintended pregnancies due to improved fertility and the absence of robust safety data during early gestation. Conclusions: GLP-1RAs present a complex clinical scenario in women of reproductive age, with potential benefits for metabolic and reproductive health but uncertain safety during pregnancy. Clinicians should exercise caution, provide appropriate contraceptive counseling, and carefully weigh the risks and benefits when prescribing these agents. Further large-scale, prospective studies are needed to clarify reproductive safety and inform evidence-based clinical guidelines. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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17 pages, 98611 KB  
Article
Epithelial Changes in the Testosterone-Dominant Vagina: Implications for Menopause, Transgender Care, and Beyond
by Sarah Montgomery and Robin R. Ingalls
Cells 2026, 15(9), 745; https://doi.org/10.3390/cells15090745 - 22 Apr 2026
Viewed by 225
Abstract
Hormonal fluctuations across female life stages drive numerous transcriptomic and epigenetic changes, yet the effects of sex hormones on mucosal immunity, particularly in the vaginal epithelium, remain poorly understood. The vaginal mucosa undergoes cyclical remodeling during the ovulatory cycle under the influence of [...] Read more.
Hormonal fluctuations across female life stages drive numerous transcriptomic and epigenetic changes, yet the effects of sex hormones on mucosal immunity, particularly in the vaginal epithelium, remain poorly understood. The vaginal mucosa undergoes cyclical remodeling during the ovulatory cycle under the influence of estrogens and progesterone produced mainly in the ovary. The ovary can also be a source of testosterone, and in postmenopausal women, as well as transgender men receiving hormone therapy, phenotypic changes in the vagina due to increased testosterone have been observed. However, the consequences of testosterone dominance in this tissue in terms of resilience and inflammation have not been well characterized. The goal of this study was to identify the histological and immunological changes within the vaginal epithelial cell barrier in an estrogen- vs. testosterone-dominant environment using an established in vitro reconstructed vaginal epithelial tissue model. Compared to estradiol, exposure to testosterone resulted in a thinner tissue with alterations in the cornification, although no impairment in the epithelial barrier was detected. Each hormone also resulted in a unique RNA expression profile, including increased expression of tight junction genes and decreased expression of chemokines and their receptors in testosterone compared to estradiol exposure. These data have implications for women’s health, including menopause, transgender men using gender-affirming hormone therapy, and other conditions associated with high testosterone in the vaginal compartment. Full article
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35 pages, 635 KB  
Review
Redox-Regulated Mitophagy and Lysosomal Dysfunction as a Convergent Mechanism in Female Infertility: Molecular Insights and Therapeutic Perspectives
by Charalampos Voros, Fotios Chatzinikolaou, Georgios Papadimas, Athanasios Karpouzos, Ioannis Papapanagiotou, Aristotelis-Marios Koulakmanidis, Diamantis Athanasiou, Kyriakos Bananis, Antonia Athanasiou, Aikaterini Athanasiou, Charalampos Tsimpoukelis, Maria Anastasia Daskalaki, Christina Trakateli, Nana Kojo Koranteng, Nikolaos Thomakos, Panagiotis Antsaklis, Dimitrios Loutradis and Georgios Daskalakis
Curr. Issues Mol. Biol. 2026, 48(4), 429; https://doi.org/10.3390/cimb48040429 - 21 Apr 2026
Viewed by 122
Abstract
Conventional hormonal and clinical models inadequately clarify the complex and diverse aspects of female infertility, resulting in poor reproductive outcomes and reduced egg viability. A growing body of research indicates that female reproductive failure is mostly due to disruptions in cellular homeostasis, especially [...] Read more.
Conventional hormonal and clinical models inadequately clarify the complex and diverse aspects of female infertility, resulting in poor reproductive outcomes and reduced egg viability. A growing body of research indicates that female reproductive failure is mostly due to disruptions in cellular homeostasis, especially concerning organelle quality control. Oxidative stress has emerged as a crucial mediator connecting metabolic, inflammatory, and ageing-related processes to ovarian failure, however its downstream impacts on intracellular organelle turnover remain insufficiently clarified. Our narrative review encapsulates the existing data for a unified pathogenic concept focused on the redox-regulated mitochondria–lysosome axis. We examine the interaction of oxidative stress, mitochondrial malfunction, compromised mitophagy, and lysosomal deficiency in granulosa cells and oocytes. Prolonged oxidative stress may disrupt this equilibrium, leading to defective mitochondria accumulation and impaired mitophagy. This self-perpetuating cycle may ultimately jeopardises reproductive viability and oocyte integrity. The integrated axis offers a shared molecular foundation for various infertility-related diseases, such as inadequate ovarian response, obesity-associated infertility, polycystic ovary syndrome, and ovarian ageing. Ultimately, we analyse new findings suggesting that specific antioxidant chemicals modify mitophagy and lysosomal function while also neutralising reactive oxygen species, highlighting their potential use in precision fertility treatments. Our research redefines female infertility as a condition of redox-dependent organelle quality control, thereby introducing novel avenues for identifying biomarkers, categorising patients, and targeting treatments in assisted reproduction. Full article
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21 pages, 3388 KB  
Article
Multi-Target Modulation of Metabolic and Steroidogenic Pathways by Cinnamomum burmannii and Myristica fragrans in Polycystic Ovary Syndrome: An Integrative Transcriptomics, Metabolomic, Pharmacoinformatics and Experimental Validation
by Taruna Ikrar, Salmon Charles Siahaan, Hendy Hendarto, Arifa Mustika, Eighty Mardiyan Kurniawati, Wiskara Jatipradresthya, Edwin Hadinata, Nurpudji Astuti Taslim, Dante Saksono Harbuwono, Raymond Rubianto Tjandrawinata and Fahrul Nurkolis
Nutrients 2026, 18(8), 1305; https://doi.org/10.3390/nu18081305 - 21 Apr 2026
Viewed by 211
Abstract
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine–metabolic disorder characterized by interconnected dysregulation of steroidogenesis and insulin signaling. Multi-target therapeutic strategies are increasingly needed to address its heterogeneous pathophysiology. Methods: An integrative approach combining transcriptomic analysis of GSE137684, including stratification of normoandrogenic [...] Read more.
Background: Polycystic ovary syndrome (PCOS) is a complex endocrine–metabolic disorder characterized by interconnected dysregulation of steroidogenesis and insulin signaling. Multi-target therapeutic strategies are increasingly needed to address its heterogeneous pathophysiology. Methods: An integrative approach combining transcriptomic analysis of GSE137684, including stratification of normoandrogenic and hyperandrogenic PCOS subtypes to capture androgen-related heterogeneity, network pharmacology, molecular docking, and in vitro validation was employed. Principal component analysis (PCA), differential expression analysis, and enrichment analyses were used to identify candidate genes and pathways. Molecular docking evaluated interactions between phytochemicals from Cinnamomum burmannii and Myristica fragrans and key PCOS targets. Functional validation was performed in insulin-resistant 3T3-L1 adipocytes and DHEA-induced KGN cells, assessing cell viability, lipid accumulation, glucose uptake, gene expression, and hormone levels. Results: PCA revealed partial separation between PCOS and the control samples, with PC1 and PC2 explaining 44.8% and 12.5% of variance, respectively. No genes remained significant after multiple testing correction; however, nominally significant candidates (p < 0.01) highlighted pathways related to steroidogenesis and metabolic regulation. Network analysis identified key hub genes including CYP17A1, CYP19A1, AKT1, ESR1, and MAPK1. Molecular docking demonstrated strong binding affinities, with top compounds showing binding energies up to −11.4 kcal/mol (CYP17A1) and −10.9 kcal/mol (AKT1). In vitro, cell viability remained above 80% across all tested concentrations, indicating low cytotoxicity. Treatment significantly reduced lipid accumulation and enhanced glucose uptake in insulin-resistant 3T3-L1 cells (p < 0.05). Additionally, expression of AKT1 and MAPK1 was significantly restored (p < 0.05). In KGN cells, testosterone levels were significantly decreased while the estradiol levels increased (p < 0.05), accompanied by the downregulation of CYP17A1 and upregulation of CYP19A1 (p < 0.05). The combination treatment exhibited more consistent effects across metabolic and hormonal endpoints. Conclusions:Cinnamomum burmannii and Myristica fragrans exert multi-target effects on metabolic and steroidogenic pathways relevant to PCOS. This integrative study demonstrates that transcriptomics-guided network pharmacology combined with experimental validation can identify synergistic phytotherapeutic strategies for complex endocrine disorders. Full article
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36 pages, 1039 KB  
Review
The Effects of Bariatric Surgery on Female Fertility: A Narrative Review
by Maria Iliopoulou, Theoharis Papageorgiou, Makarios Eleftheriadis, George Mastorakos and Georgios Valsamakis
Int. J. Mol. Sci. 2026, 27(8), 3665; https://doi.org/10.3390/ijms27083665 - 20 Apr 2026
Viewed by 190
Abstract
Obesity is associated with menstrual dysfunction, anovulation, and infertility, particularly in women with polycystic ovary syndrome (PCOS). This narrative review summarizes evidence on the effects of bariatric surgery [focusing on sleeve gastrectomy (SG) Roux-en-Y gastric bypass (RYGB)] on female reproductive function and fertility [...] Read more.
Obesity is associated with menstrual dysfunction, anovulation, and infertility, particularly in women with polycystic ovary syndrome (PCOS). This narrative review summarizes evidence on the effects of bariatric surgery [focusing on sleeve gastrectomy (SG) Roux-en-Y gastric bypass (RYGB)] on female reproductive function and fertility outcomes. Developed according to SANRA (Scale for the Assessment of Narrative Review Articles) principles, a structured search of PubMed, Scopus, and Web of Science (English language; inception–30 September 2025) was conducted, using fertility-related terms (e.g., fertility, ovulation, IVF/ART, AMH, PCOS, pregnancy, live birth, time to conception) combined with bariatric surgery terms (SG/VSG, RYGB, metabolic/bariatric surgery, and weight loss surgery). Guidelines from IFSO, BOMSS, and ASMBS were also reviewed. Findings were synthesized narratively. Across mainly observational studies, bariatric surgery is associated with improved menstrual regularity, increased ovulation, reduced hyperandrogenism, and improved insulin sensitivity, with higher conception rates reported after substantial weight loss. AMH responses are inconsistent across studies and their clinical significance remains uncertain. SG and RYGB appear to improve fertility-related outcomes in women with obesity. Programming of pregnancy and nutritional monitoring are critical. In conclusion, long-term, standardized reproductive endpoints are needed to clarify bariatric surgery-associated effects during pregnancy. Full article
(This article belongs to the Collection Latest Review Papers in Endocrinology and Metabolism)
21 pages, 1545 KB  
Review
Extracellular Matrix Remodeling and Matrix Metalloproteinases in Ovarian Function and Infertility
by Efthalia Moustakli, Athanasios Zikopoulos, Periklis Katopodis, Vasilios Sebastian Paraschos, Ioannis Messinis and Christina Messini
Int. J. Mol. Sci. 2026, 27(8), 3652; https://doi.org/10.3390/ijms27083652 - 19 Apr 2026
Viewed by 323
Abstract
Ovarian function relies on a network of well-coordinated molecular mechanisms that regulate follicular development, oocyte maturation, ovulation, and corpus luteum function. When these processes are disrupted, infertility can result. Extracellular matrix (ECM) remodeling represents a central regulatory component in these processes and is [...] Read more.
Ovarian function relies on a network of well-coordinated molecular mechanisms that regulate follicular development, oocyte maturation, ovulation, and corpus luteum function. When these processes are disrupted, infertility can result. Extracellular matrix (ECM) remodeling represents a central regulatory component in these processes and is essential for follicle rupture and oocyte release. This mechanism involves metalloproteinases (MMPs), mainly MMP-2 and MMP-9, which degrade the ECM and allow the necessary structural changes. Other ECM-modulating proteases, such as ADAM and ADAMTS families, also contribute to this process. Their activity is tightly regulated by tissue inhibitors of metalloproteinases (TIMPs), ensuring that tissue remodeling occurs in a controlled manner. Disruption of the balance between MMPs and TIMPs increases the risk of infertility-related conditions such as polycystic ovary syndrome (PCOS), endometriosis, luteinizing hormone (LH) deficiency syndrome, and ovarian aging. In addition to the ECM, other factors, including intracellular signaling pathways, oxidative stress (OS), and mitochondrial function, contribute to ovarian physiology and directly affect oocyte quality and viability. This narrative review focuses on the molecular mechanisms governing ovarian function, with particular emphasis on the remodeling of the ECM by MMPs during ovulation, and examines how their disorders contribute to infertility. A deeper understanding of these mechanisms may lead to the identification of new therapeutic targets and the improvement of assisted reproduction outcomes. Full article
(This article belongs to the Special Issue Molecular Pathways to Infertility)
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24 pages, 937 KB  
Review
Diagnostic Criteria and Genetic Basis of Polycystic Ovary Syndrome: A Narrative Review
by María de los Angeles Cepero-González, Adriana Aguilar-Galarza, Víctor Manuel Rodríguez-García, Teresa García-Gasca and Ulisses Moreno Celis
Metabolites 2026, 16(4), 277; https://doi.org/10.3390/metabo16040277 - 19 Apr 2026
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Abstract
This study reviews the main candidate genes involved in the pathophysiology of Polycystic Ovary Syndrome (PCOS). PCOS is a common endocrine–metabolic disorder in women of reproductive age, characterized by menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. It is associated with increased metabolic and [...] Read more.
This study reviews the main candidate genes involved in the pathophysiology of Polycystic Ovary Syndrome (PCOS). PCOS is a common endocrine–metabolic disorder in women of reproductive age, characterized by menstrual irregularity, hyperandrogenism, and polycystic ovarian morphology. It is associated with increased metabolic and cardiovascular risk and is a leading cause of infertility. Although its pathophysiology is not fully understood, alterations in the hypothalamic–pituitary–ovarian axis, insulin metabolism, and steroidogenesis have been described. Polymorphisms in genes encoding hormones, enzymes, and receptors in these pathways contribute to clinical variability and ethnic differences, offering potential for early diagnosis and personalized medicine. This review summarizes key candidate genes related to insulin metabolism (INS, INSR, IRS-1), the hypothalamic–pituitary–ovarian axis (LHβ, LHCGR, FSHR, GnRHR, AMH, AMHR2, KISS1, CAPN10), steroidogenesis (CYP11A, CYP17A1, CYP19A1, CYP21, 17β-HSD, SHBG, AR, STAR), and other clinically relevant mechanisms such as obesity, lipid metabolism (PPARG, VDR, FTO), and follicular development (ACE). Full article
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