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Thus, in this complex scenario, other factors could lead to hypogonadism in diabetic subjects, such as the resistance to GnRH-stimulating effects of leptin in patients with obesity, the suppressive action of leptin on the stimulatory action of Gn on the Leydig cells, and finally, the increase of inflammation that leads to the suppression of hypothalamic GnRH secretion [60-62]
Furthermore, the integration of omics technologies and biomarker-based screening strategies may aid in identifying patient subgroups most likely to benefit from natural product-based interventions, ultimately enabling more precise and personalized IVF management for DOR patients