Investigating the stereological and oxidative stress effects of hydroalcoholic extracts of <i>Cynara scolymus</i> L. and pioglitazone on diabetic rat ovary

Women with diabetes frequently experience ovarian dysfunction, which is a significant indication that diabetes adversely affects their reproductive health. This study investigates the efficacy of combined treatment with Pioglitazone and Cynara scolymus extract in improving ovarian function in streptozotocin-induced diabetic rats. A total of 35 female rats were divided into five groups: (1) Control (saline), (2) DM (diabetic control), (3) DM + Piog (30 mg/kg Pioglitazone), (4) DM + Cynara (400 mg/kg C. scolymus extract), and (5) DM + Piog + Cynara (combined treatment), and were administered orally for 30 consecutive days. Following treatment, histopathological and stereological analyses were performed to evaluate follicular development, corpus luteum volume, and oxidative stress markers. The results indicated that the combined treatment (DM + Piog + Cynara) led to significant improvements, including increased numbers of preantral, antral, and Graafian follicles, alongside an enhanced corpus luteum volume. Additionally, there was a notable reduction in atretic follicles and fasting blood glucose levels compared to the diabetic group. Diabetes resulted in elevated malondialdehyde (MDA) levels and decreased antioxidant enzyme activities. However, the combination therapy effectively modulated apoptotic pathways, enhancing Bcl-2 expression while reducing Caspase-9 activity. This study demonstrates that the combined therapy of C. scolymus extract and Pioglitazone mitigates diabetic-induced ovarian dysfunction by reducing oxidative stress, normalizing hormonal levels, and promoting healthy folliculogenesis. These findings suggest that this approach may serve as a promising complementary treatment for diabetes-related reproductive issues, potentially improving reproductive health.