The impact of nicotinamide mononucleotide on ovarian health: A comprehensive literature review of preclinical evidence and therapeutic potential

Nicotinamide mononucleotide (NMN), a key precursor of nicotinamide adenine dinucleotide (NAD+), has recently emerged as a promising therapeutic candidate for age-related diseases. This review critically evaluates preclinical evidence regarding the effects of NMN on ovarian health, with particular emphasis on its potential to attenuate ovarian aging, improve follicular reserve, and restore endocrine function. Animal studies have demonstrated that NMN supplementation enhances mitochondrial function, reduces oxidative stress, and modulates sirtuin activity in ovarian tissue. These effects contributed to improved oocyte quality, delayed ovarian senescence, and prolonged reproductive lifespan. In models of chemotherapy-induced ovarian insufficiency and age-related ovarian decline, NMN administration was associated with increased folliculogenesis and normalization of hormonal profiles. Furthermore, the anti-inflammatory and anti-apoptotic properties of NMN suggest potential therapeutic applications in conditions such as premature ovarian insufficiency and polycystic ovary syndrome. Despite encouraging findings in rodent models, clinical translation remains limited. This review summarizes the key molecular pathways influenced by NMN, including the NAD+/sirtuin-1 (SIRT1) axis, and highlights important gaps in current knowledge. Collectively, the available evidence underscores the therapeutic potential of NMN while emphasizing the need for well-designed human studies to establish its efficacy and safety in reproductive medicine.