Role of <em>Aloe Barbadensis</em> Mill. as a Possible Pre- Conceptive Herb for the Management of Polycystic Ovarian Syndrome: A Rodent Model Study

Research Article

Austin J Reprod Med Infertil. 2016; 3(2): 1040.

Role of Aloe Barbadensis Mill. as a Possible Pre- Conceptive Herb for the Management of Polycystic Ovarian Syndrome: A Rodent Model Study

Radha MH and Laxmipriya NP*

Department of Biochemistry, Maharaja Sayajirao University of Baroda, India

*Corresponding author: Nampoothiri P Laxmipriya, Department of Biochemistry, Maharaja Sayajirao University of Baroda, Sayajigunj, Vadodara-390 002. Gujarat, India

Received: July 12, 2016; Accepted: September 06, 2016; Published: September 08, 2016


Purpose: Current research is oriented towards identifying herbal therapeutic options for management of the complications. Aloe vera gel (AVG) (10 mg dry weight orally/60 days/daily) demonstrated improvement in the PCOS phenotype in non-pregnant stage and to understand the role of AVG as a pre-conceptive agent in PCOS.

Methods: Letrozole induced PCOS rat model was developed and treated with Aloe vera gel for 2 months (10 mg dry weight orally/60 days/daily), which was followed by induction of pregnancy. Animals were sacrificed at late gestational period (18th -20th day) and assayed for biosynthetic and metabolizing enzymes of steroidogenesis. Also, key steroid hormone status as well as its regulatory proteins levels was also evaluated.

Results: Results showed that reproductive performance was improved in PCOS rats after treating with AVG, suggesting that it had protective effect. AVG also altered the ovarian-placental steroid status by modulating the expression of Steroidogenic acute regulatory (StAR), Luteinizing hormone receptor (LHR), Androgen Receptor (AR) and Aromatase, which could also be correlated with a change in hormonal profile of important steroids. AVG also reduces post implantation loss during gestation period leading to increased foetal viability “at term”.

Conclusion: These modulations could be attributed to the nutritive and active ingredients present in Aloe vera gel, which independently or cumulatively act to regain fertility when used prior to conception. Thus, suggesting AVG is a good pre-conceptive agent for PCOS phenotype.

Keywords: Polycystic ovary syndrome; Infertility; Insulin resistance; Aloe vera; Pre-conceptive agent


Polycystic Ovarian Syndrome (PCOS) is the most common endocrine abnormality in reproductive aged women, affecting approximately 5-10% of this population [1]. The clinical characteristics include oligo or an ovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovaries at ultrasound [2]. In addition, PCOS women suffer from several clinical and metabolic complications like RPL (Recurrent pregnancy loss), gestational diabetes, pre-clampsia during gestation period. Studies have demonstrated that the nutritional status of foetus is hampered in females suffering from PCOS [3]. Various aetiologies have been proposed [4-6] to understand the detailed pathology. Gonadotropin abnormalities with characteristic increased GnRH pulse frequency have been recognized as a factor to cause an elevation in LH/FSH [7] ratio, which could be a risk factor for spontaneous abortions and increased early pregnancy loss [8]. Hyperinsulinemic PCOS females are more likely to produce oocytes exhibiting low fertilization rates after IVF treatment and embryos which are unable to implant [9]. It is also evident from literature that insulin affects endometrial receptivity [10]. Hence, both insulin resistance and hyperandrogenism could affect foetal development [11] and alter “in utero” condition during pregnancy [12].

As insulin resistance is the fundamental co-morbidity associated with PCOS, current available treatment is the use of insulin sensitizers like metformin along with an ovulatory agent like clomiphene citrate in order to manage fertility [13]. But, these drugs have profound side effects upon prolonged usage [14]. Recent studies are suggesting evidence of teratogenicity associated with metformin treatment during pregnancy [15]. Hence, currently researchers are exploring alternative therapy to treat and manage the infertility disorders [16].

In this regard, several complimentary therapies have been studied for management of PCOS that ultimately helps to regain the fertility. Several traditional Chinese medicines (TCM) and ayurvedic medicines have been reported to help in ovulation and reduce pregnancy related complications [17]. Researchers have implicated that targets of phytocomponents could be steroid receptors, steroid metabolizing enzymes and proteins involved in implantation [18]. These modulatory effects might help in treatment of ovarian dysfunction and restoration of fertility [19]. Many indigenous plants have been reported to be used in traditional herbal remedies during pregnancy and childbirth. However, none of the previous studies demonstrate the potential of the herbal extracts towards management of PCOS pathology and its associated pregnancy related complications. In this context, Aloe vera was extensively evaluated for a prospective pre-conceptive herbal therapy in PCOS pathology.

A. vera has been used in folk medicine for over 2000 years, and has remained an important component in the traditional medicine of many contemporary cultures, such as China, India, the West Indies, and Japan [20]. In view of above, various Aloe species have gained popularity as therapeutic, botanicals and biological properties of A. vera [21]. Various extracts of these Aloe species are traditionally used and their application used to cure arthritis, skin cancer, burns, eczema, psoriasis, digestive problems, high blood pressure, and diabetes [22]. The components of gel include proteins, lipids, amino acids, vitamins, enzymes, inorganic compounds and different carbohydrates [21]. This effect would be correlated with phyto-components present in AVG.

The mechanism of phytosterol action is based on its ability to reduce cholesterol absorption and thereby, improves the hyperlipidemic condition [23,24]. In addition to this, previous work has already shown that Aloe vera gel (AVG) causes reversion of estrous cyclicity and improves steroid status in PCOS rat model [25] and it also acts as an anti-hyperlipidemic agent in non-pregnant stage [26]. However, there are no studies that demonstrate the potential of Aloe vera gel as a pre-conceptive agent in PCOS pathology. Hence, the aim of the present study was to study the role of Aloe vera gel as a pre-conceptive agent in PCOS phenotype, wherein, it can manage the pathophysiology and render fewer chances of miscarriages and improve the fertility.

Materials and Methods

Aloe vera gel extraction

Aloe barbadensis Mill. (Voucher no. PSN 723) was compared with the specimen (Bhatt 2486, 653, 279, JVJ 448) lying with the nationally recognized BARO Herbaria of the Department of Botany, The M.S. University of Baroda, Vadodara, Gujarat, India. Fresh mature Aloe vera leaves (3.5 years old) were taken and washed with water. Later, the leaves were incised with the sterilized knife and allowed to stand by for 2 hours in order to remove the aloin. Later, the gel was removed by separating the epidermis and was sonicated to get a homogenous gel.

Animals and treatment regime

Adult Charles foster female rats (weight 150-200 g) were used for the study. All rats were housed in cages and maintained in ambient temperature of 25±1°C and 45.5% relative humidity, with a photoperiod cycle of 12 h:12 h (light and dark) with food and free access of water. All experimental protocols were approved by the institutional animal ethical committee according to CPCSEA guidelines. After treatment regime, rats of all groups were allowed to mate with male rats. The date of copulation was determined on the basis of vaginal smears, wherein, presence of sperm in vaginal smear was considered as the first day of pregnancy. At the end of gestation period: 18th-20th day, rats were sacrificed and assessed for various biochemical, molecular parameters along with fertility index.

Detailed plan of work in mentioned in Figure 1.