Ethanol Extract from Yellow Pumpkin Modulate Hormonal Levels and Ovarian Follicle Dynamics in Hypoestrogenic Wistar Rats

Depo Medroxyprogesterone Acetate (DMPA) is a progesterone analog that induces a hypoestrogenic response by inhibiting gonadotropin-releasing hormone (GnRH) needed for the release of follicle-stimulating hormone (FSH) and Luteinizing Hormone (LH), thereby preventing ovulation, decreasing the number of antral follicles, and suppressing stromal and epithelial cell proliferation. Side effects of DMPA can be reduced by using natural ingredients such as yellow pumpkin seeds (Cucurbita pepo L.). This study aimed to determine the effect of pumpkin seed ethanol extract on FSH levels and activation of Ki-67 expression in endometrial stromal cells, beta estrogen receptors, antral follicles, stromal cells, and endometrial epithelial cells in hypoestrogen type Wistar rats with DMPA injection. This in vivo study used 25 female rats (Rattus norvegicus) that were randomly divided into five groups: a control group and four treatment groups. The control group, without DMPA (sterile aquadest injection), as well as the treatment groups, were injected with a dose of 2.7 mg/kg bw of DMPA every 3 days for 21 days. Ovarian FSH levels were evaluated by ELISA, Ki-67, and ERβ expression by immunohistochemistry (IHC), antral follicle count, stromal cells, and endometrial epithelium by Hematoxylin Eosin (HE). The findings of the study revealed significant differences and correlations between extract dose and FSH levels, Ki-67 expression, ER-beta, antral follicle count, stromal cells, and endometrial epithelial cells. The result of the study showed that yellow pumpkin seed ethanol extract in various doses enhanced FSH levels, Ki-67 expression, ER-beta, antral follicle count, stromal cell count, and endometrial epithelial cell count compared to a positive control group exposed only to DMPA.