Spontaneous pregnancy in a woman with diminished ovarian reserve following dietary supplementation with major royal jelly proteins: A case report.

RATIONALE: Royal jelly (RJ), a natural secretion produced by the hypopharyngeal and mandibular glands of worker honeybees, is a nutrient-rich substance that contains proteins, lipids, vitamins, and bioactive compounds. Among its key components, major royal jelly proteins (MRJPs) constitute the predominant fraction and have been linked to various physiological benefits. Our previous studies on female mice have shown that MRJPs can increase uterine and ovarian indices, estradiol levels, and endometrial thickening. Overexpression of MRJPs in female Drosophila can increase estrogen levels and activate cell proliferation signaling pathways, thereby promoting body growth. Therefore, we speculate that MRJPs may be helpful for women. Here, we describe a woman with diminished ovarian reserve (DOR) who conceived naturally at week 4 after receiving oral MRJPs, an observation that warrants further investigation.

PATIENTS CONCERNS: A 35-year-old female who was diagnosed with DOR through hormone testing before MRJPs administration. The clinical manifestations included dysmenorrhea and poor sleep. After taking the MRJPs, she conceived naturally.

DIAGNOSES: The patient underwent hormonal testing at a specialized hospital and was diagnosed with DOR.

INTERVENTIONS: The patient started taking 1g lyophilized powder of MRJPs (provided by Hangzhou Aili Biotechnology Co., Ltd. using ultrafiltration-mediated enrichment to retain MRJPs with a molecular weight of 4.9 × 104) orally in the morning and evening, respectively.

OUTCOMES: The patient conceived naturally following 4 weeks of continuous MRJPs supplementation. During the administration of MRJPs, patients were monitored and asked about gastrointestinal and allergy-related adverse reactions. The results showed that no confirmed cases of gastrointestinal discomfort (including bloating, dull pain, cramps, nausea, or diarrhea) or allergic reactions (skin erythema, pruritus, or urticaria) occurred throughout the entire observation period.

LESSONS: Given the non-generalizable nature of this single-case report, a randomized double-blind clinical trial has been arranged. The mechanisms of MRJPs require further elucidation, and potential lifestyle confounders such as sleep quality and physical activity were not objectively monitored.