Clinical relevance of melatonin in ovarian and placental physiology: a review.

Within the last decade, the synthesis of melatonin in and its functions at the level of the peripheral reproductive organs has come into better focus. Melatonin is produced at several reproductive organ sites, e.g., the oocyte, ovarian follicular cells and the placental cytotrophoblasts. Moreover, these cells also contain membrane receptors for this indoleamine. In addition, via the free radical scavenging activity of melatonin and its metabolites, oxidative stress is reduced in all reproductive organ cells ensuring their optimal function. Enhancement of oocyte maturation and preservation of oocyte quality may be major functions of melatonin. Oocyte damage reduces successful fertilization and the development of a healthy fetus. The findings that melatonin protects the oocyte from toxic oxygen species have implications for improving the outcome of in vitro fertilization-embryo transfer procedures, as already shown in two published reports. Some actions of melatonin in the placenta may be context specific. Thus, melatonin is believed to function in the maintenance of optimal placental homeostasis by deferring apoptosis of villous cytotrophoblasts, while protecting syncytiotrophoblasts from oxidative damage. Melatonin reduces oxidative damage in the placenta and may improve hemodynamics and nutrient transfer at the placental-uterine interface. The use of melatonin to treat preeclampsia should also be considered.