Melatonin in Female Fertility: Multifaceted Role From Reproductive Physiology to Therapeutic Potential in Polycystic Ovary Syndrome, Endometriosis, and Ovarian Failure

Melatonin, synthesized by the pineal gland, plays a pivotal role in female reproductive physiology. In addition to its established function in regulating circadian rhythms, melatonin influences critical reproductive processes, such as ovulation, menstrual cycle regulation, and fertility. Recent studies underscore melatonin’s regulatory effects on the hypothalamic-pituitary-gonadal axis, influencing the secretion of gonadotropins, including follicle-stimulating hormone and luteinizing hormone. Furthermore, melatonin has been implicated in the pathophysiology of reproductive disorders, such as polycystic ovary syndrome and endometriosis, where its antioxidant and anti-inflammatory properties may enhance ovarian function and fertility. Melatonin also plays a protective role against oxidative stress in granulosa cells, thereby improving oocyte quality and increasing the potential for successful fertilization. These effects position melatonin as a promising therapeutic agent in assisted reproductive technologies, such as in vitro fertilization. Studies demonstrate that melatonin supplementation mitigates the harmful effects of reactive oxygen species on ovarian cells, enhancing embryo development and improving pregnancy outcomes. By counteracting oxidative stress and apoptosis in reproductive tissues, melatonin emerges as a crucial factor in promoting reproductive health.