krocina, improves in vitro fertilization outcomes in patients with diminished ovarian reserve: a randomized controlled trial

Background: diminished ovarian reserve (dor) is a clinical syndrome with reproductive and endocrine disorders. this study aimed to examine the effect of crocin on oxidative stress, gene expression, oocyte maturation, and embryo quality in dor patients who underwent a controlled ovarian hyperstimulation (coh) cycle.methods: as a clinical trial, this study involved 34 dor patients trying to conceive by assisted reproductive technique who were divided into two groups (17 each): an intervention group receiving crocin (15 mg, once daily, for 12 weeks) and a control group receiving a placebo (tablets with the same form of the drug). pre- and post-intervention, demographic information was gathered, and hormonal levels (follicle-stimulating hormone (fsh), luteinizing hormone (lh), and estradiol (e2)) were measured. in the subsequent coh cycle, oocyte maturation, embryo quality, level of both superoxide dismutase (sod) and reactive oxygen species (ros) in follicular fluid, expression of gdf9, bmp15, and nrf2 genes in granulosa cells were measured.results: the collected data as a comparison between groups showed alteration of criteria in the intervention group as follows: significant reduction of fsh (p<0.01), increased level of sod in the follicular fluid (p<0.0001), decreased level of oxidative stress in the granulosa cells (p<0.0001), increased expression of nrf2 gene (p<0.08), and of gdf9, bmp15 genes (p<0.0001) in the granulosa cells. the rate of oocyte maturation and embryo quality were significantly higher in the intervention group compared to the control group (p<0.05 and p<0.005, respectively).conclusion: our study discussed how the krocina supplement can slow down the progression of the disease by reducing the level of fsh, and oxidative stress, increasing the maturation rate of oocytes, and increasing the quality of embryos in women with dor. further research is needed to investigate the effect of crocin in improving fecundity for women with dor.