Table 2.

Preclinical studies supporting the use of N. sativa to manage PCOS

S.No	Study design	Outcome
1	Animal study (PCOS-induced rats) [34]	• Marked elevation of TAC and reduction of MDA.
2	Animal study (estradiol valerate-induced PCOS rats) [35]	• Significant improvements in ovarian morphology, ovarian function, and ovulation similar to metformin.
		• Significant reduction of number of follicular cysts along with an increase in number of primary follicles, antral follicles, Graafian follicles and corpus luteum.
		• Reversal of serum biochemical parameters including glucose, TGs, TC, LDL-c, HDL-c, LH, and FSH.
3	Animal study (letrozole-induced PCOS female Sprague-Dawley rats) [36]	• Significant increase of number of rats undergoing regular cycle, average number of regular cycles, appearance of corpus luteum and decreased number of cystic follicles.
		• Reduction of LH, testosterone, FSH, body weight, FBG, TC, LDL-c, TGs, and MDA.
		• Increased levels of HDL-c, SOD, and GPX.
4	Animal study (dehydroepiandrosterone-induced PCOS mice) [37]	• Significant improvements in maturation, fertilization, and blastocyst formation.
		• Increased glutathione concentration and glutathione peroxidase mRNA expression in oocytes.
5	Animal study (letrozole-induced PCOS Wistar rats) [38]	• Significant improvements in serum levels of LH, FSH, estrogen, testosterone and progesterone.
6	Animal study (dehydroepiandrosterone (DHEA)-induced PCOS Wistar female rats) [39]	• Significant lowering of serum levels of LH, estrogen, testosterone, insulin, insulin resistance, glucose, and malondialdehyde (MDA).
		• Increased serum levels of progesterone and antioxidant enzymes such as SOD, GPX and CAT.
		• Reversal of pathological changes of primary follicles by increasing number of graafian follicles and decreasing number of cystic follicles and atretic follicles.