Restoring ovarian function in PCOS: Ethanol extract of Alocasia indica tuber attenuates hormonal imbalance, oxidative stress, and cystic follicles in a letrozole-induced rat model

• EEAIT restored estrous cyclicity in letrozole-induced PCOS rats on HFD. • Hormonal imbalance and serum hsCRP levels were significantly improved by EEAIT. • EEAIT reduced oxidative stress and boosted antioxidant enzymes in GCs and uterus. • Histopathology showed reversal of uterine hypertrophy and cystic follicle decline. Alocasia indica , synonymous with Alocasia macrorrhizos (Araceae), corresponds botanically to the species documented in the Traditional Chinese Medicine (TCM) pharmacopeia, where A. macrorrhizos —referred to as Hai Yu—is commonly found throughout southern China. In TCM literature, A. macrorrhizos is incorporated into herbal formulations for conditions associated with inflammation, metabolic dysfunction, and oxidative stress key pathophysiological features of polycystic ovarian syndrome (PCOS). Forty-eight female Wistar rats were randomly divided into two initial sets (n = 24 each). Set-1 (Initial Control) received a normal diet (ND) and 1% carboxymethyl cellulose (CMC), while Set-2 (Initial PCOS) was fed a high-fat diet (HFD) and administered letrozole (1 mg/kg body weight, dissolved in 1% CMC) for 21 days to induce PCOS. On day 22, six rats from each set were sacrificed for histological confirmation. The remaining rats were subdivided into six groups and maintained on ND for 28 days. From Set-1, Group A received CMC, Group B (E200) received 200 mg/kg BW EEAIT, and Group C (E400) received 400 mg/kg BW EEAIT. From Set-2, Group D received letrozole alone, Group E (PCOS+E200) received 200 mg/kg BW EEAIT, and Group F (PCOS+E400) received 400 mg/kg BW EEAIT. Estrous cyclicity was monitored during the initial and final four days of both phases. Letrozole administration resulted in irregular estrous cycles, hormonal imbalance, elevated oxidative stress, increased serum hs-CRP levels, and altered ovarian and uterine weights. EEAIT treatment at both doses significantly improved estrous cyclicity, normalized hormone levels, reduced hs-CRP, restored antioxidant status, and improved ovarian and uterine histoarchitecture compared to the PCOS control group. EEAIT effectively ameliorates hormonal, inflammatory, and oxidative disturbances in letrozole-induced PCOS rats, supporting its therapeutic potential and providing scientific rationale for pharmacological activities associated with its taxonomical counterpart in TCM.