Gynura procumbens Leaf Extract Nanoparticles and Anti-Müllerian Hormone (AMH) in a Polycystic Ovary Syndrome (PCOS) Rat Model: A Systematic Literature Review of Evidence Gaps and Research Opportunities

Abstract

Polycystic ovary syndrome (PCOS) is a complex endocrine-metabolic disorder. It involves hyperandrogenism, ovulatory dysfunction, insulin resistance, low-grade inflammation, oxidative stress, and altered ovarian morphology. Anti-Müllerian hormone (AMH) is a key biomarker. It is primarily produced by granulosa cells of preantral and small antral follicles. AMH is typically elevated in PCOS. Gynura procumbens (Lour.) Merr. exhibits antioxidant, anti-inflammatory, and metabolic activities relevant to PCOS pathophysiology. Nanoparticle technology may enhance the dispersibility, stability, and delivery of its active compounds. This review synthesizes 2021–2026 scientific evidence on G. procumbens pharmacology, nanoformulation, herbal nanoparticle efficacy in PCOS models, and the role of AMH as a PCOS biomarker/mediator. It also identifies research gaps regarding G. procumbens nanoparticle effects on AMH. The review followed PRISMA 2020 methodology. Searches were conducted in PubMed/MEDLINE, Scopus, ScienceDirect, Google Scholar, and additional academic sources. The search was limited to 2021–2026. A layered search strategy mapped four domains: G. procumbens, nanoformulation, PCOS, and AMH. G. procumbens contains polyphenols with antioxidant and anti-inflammatory activity. In vitro studies show modulation of COX-2, NF-κB, PI3K/Akt, and MAPK. Nanoformulation studies (chitosan nanoparticles, self-microemulsifying systems, nanoliposomes) demonstrated improved delivery and biological effects in animal models. In PCOS rat models, curcumin, naringenin, and other plant-based nanoparticles improved hormonal, metabolic, histological, or ovulatory outcomes. Recent studies reinforce the causal role of AMH/AMHR2 in the PCOS phenotype. However, no primary study has directly tested the combination of G. procumbens nanoparticles and AMH outcome in PCOS rat models. Convergent evidence provides a reasonable biological basis for experimental research. The relationship remains a hypothesis, not proof of efficacy.