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Sixty rats were divided into five groups (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200912): control, PCOS, PCOS\u2009+\u2009LSSE (250 mg\/kg), PCOS\u2009+\u2009LSSE (500 mg\/kg), and metformin (200 mg\/kg). Half of the rats were euthanized after four weeks, while the remaining rats were housed with males (1 male: 2 females) for testing pregnancy outcomes. LSSE led to remarkable improvements in body weight, glucose, sex hormonal balance, liver and kidney functions, antioxidant and anti-inflammatory systems, mating and fertility indices, pregnancy outcomes, and fetal morphology. Histologically, LSSE treatment reduced ovarian cyst number and size, and enhanced the blood vessel, Graafian follicle, and endometrial morphologies. LSSE showed dose-dependent effects, with the high-dose demonstrating superior results in the biochemical parameters, while the low-dose showed the most promising pregnancy outcomes. LSSE exhibits potent protective effects against PCOS, surpassing metformin in several aspects. LSSE acts through multi-mechanistic action, including anti-inflammatory, antioxidant, metabolic, and hormone-balancing properties, along with its positive impact on fertility, suggesting that LSSE could be a promising natural alternative for PCOS management.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical Abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s43032-025-01820-y","type":"journal-article","created":{"date-parts":[[2025,3,6]],"date-time":"2025-03-06T10:23:24Z","timestamp":1741256604000},"page":"1338-1361","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Lepidium Sativum\u00a0Extract Alleviates Reproductive and Developmental Toxicity in\u00a0Polycystic Ovary\u00a0Syndrome\u00a0Induced by Letrozole and High-Fat Diet in\u00a0Rats"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5837-8944","authenticated-orcid":false,"given":"Mariam Ahmed","family":"Moustafa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-6964","authenticated-orcid":false,"given":"Ayman Saber","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1175-5647","authenticated-orcid":false,"given":"Ahmed Imam","family":"Dakrory","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0562-4538","authenticated-orcid":false,"given":"Mennatallah H.","family":"Abdelaziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,6]]},"reference":[{"key":"1820_CR1","doi-asserted-by":"publisher","first-page":"e27943","DOI":"10.7759\/cureus.27943","volume":"14","author":"A Jabeen","year":"2022","unstructured":"Jabeen A, Yamini V, Rahman Amberina A, Dinesh Eshwar M, Vadakedath S, Begum GS, et al. 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