The Effects of Foeniculum vulgare Seed Extract on Fertility Results of Assisted Reproductive Technology in Women With Poor Ovarian Response

Infertility is considered the main problem of many couples worldwide (1). Female infertility is associated with unpleasant social outcomes (2) and different psychological problems (3). Ovarian function is the main issue that is addressed in counseling the infertile people who should undergo treatment with different protocols of ovarian stimulation (4,5). However, some women do not respond well to the standard protocol stimulation regimen and cannot recruit adequate follicles. According to (6), these patients are called ‘poor ovarian responders (PORs)’. In vitro fertilization (IVF) is one of the most common and relatively new treatments in assisted reproductive technologies (ARTs) and is associated with great success in the treatment of female infertility (7). However, in some cases, namely, poor responders, the ovary does not respond appropriately to stimulation and ovulation induction. For instance, poor response to ovarian stimulation was reported in 9%-24% of patients who had IVF (8). Moreover, the prevalence rate may have been underestimated because of inadequate assessments (9). It is necessary to develop specific therapeutic processes and therapeutic strategies to achieve better outcomes in the treatment of ovarian failure. Many women with ovarian failure need to undergo IVF which has a relatively high failure rate; therefore, the development of therapeutic approaches and interventions seems essential (9). The use of herbal drugs and nature-based products is one of the popular treatments that have recently become widespread. This is due to fewer side effects following the use of the plants in the treatment of diseases (10, 11). Fennel (Foeniculum vulgare Mill), which is from family Apiaceae (Umbelliferae), i s a perennial plant that occurs in Mediterranean regions. The dried seeds of F. vulgare have pleasant taste and odor and are used as odor and taste-producing agents in food industries. In Abstract Objectives: Foeniculum vulgare due to phytoestrogens is important in the treatment of female sexual dysfunction including infertility. Accordingly, this study was conducted to investigate the effect of the F. vulgare seed extract on the fertility results of assisted reproductive technology (ART) in women with a poor ovarian response (POR). Materials and Methods: In this before-after intervention, 19 infertile women with POR were enrolled by a convenience sampling method. T h e amounts of luteinizing hormone ( LH) and follicle-stimulating hormone (FSH), ovarian ultrasound volume, the number of preantral follicles, and the size of the prominent ovary were measured before treatment with F. vulgare. Then, patients were treated with F. vulgare for two months, followed by initiating the in vitro fertilization (IVF) cycle. The number of embryos transferred in previous and current cycles was investigated after IVF. Finally, the data were analyzed in SPSS 16. Results: There was a significant difference in the serum LH level (P = 0.002), LH/FSH (P = 0.049), the number of follicles and ovules (P = 0.003), endometrial thickness (P = 0.04), and ovarian volume (P = 0.03) between before and after treatment with F. vulgare. Moreover, a significant difference regarding the decreased number of required days for induction was observed between before and after treatment with F. vulgare (P = 0.022). Conclusions: In general, the use of F. vulgare had positive effects on improving t h e quality of oocytes and female fertility indices in women with POR.