Objective: To explore the mechanism of action of estradiol tablets/estradiol and dydrogesterone tablets (Femoston) in regulating the hypothalamic-pituitary-ovarian (HPO) axis to improve ovarian reserve and endometrial receptivity in mice with premature ovarian failure complicated by chronic psychological stress. Methods: Thirty 8-week-old female kunming mice were randomly divided into a control group, a premature ovarian failure combined with chronic psychological stress model group, and a Femoston treatment group, with 10 mice in each group. The model group and the Femoston treatment group were established with models of premature ovarian failure and chronic psychological stress. The Femoston treatment group was given Femoston (0.3 mg/kg) by gavage for 4 weeks, while the control group and the model group were given normal saline by gavage. After the experiment, the levels of serum sex hormones, pathological changes of ovarian and uterine tissues, the content of leukemia inhibitory factor (LIF) in endometrial tissues, and the expression of genes related to the HPO axis were detected. Results: Compared with the control group, the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the serum of mice in the model group increased, while the level of estradiol (E2) decreased; the number of antral follicles in the ovary decreased, and interstitial cell hyperplasia occurred; the endometrium became thinner, the number of glands decreased and was irregular, and the LIF level decreased; the expression of FSHβ and LHβ genes increased, while the expression of gonadotropin-releasing hormone (GnRH), estrogen receptor α (ERα), and estrogen receptor β (ERβ) genes decreased (all P<0.05). Compared with the model group, the levels of FSH and LH in the Femoston treatment group decreased, and the level of E2 increased; the number of primary follicles in the ovary increased, and interstitial cell hyperplasia was alleviated; the endometrial thickness increased, the glandular structure improved, and the LIF level increased; the expression of FSHβ and LHβ genes decreased, while the expression of GnRH, ERα, and ERβ genes increased (all P<0.05). Conclusion: Femoston can regulate the HPO axis and improve the ovarian reserve and endometrial receptivity in mice with premature ovarian failure complicated by chronic psychological stress.

Estradiol Tablets/Estradiol and Dydrogesterone Tablets, Premature Ovarian Failure, Chronic Psychological Stress, Ovarian Reserve, Endometrial Receptivity