Ovarian aging, a condition that results in decreased ovarian functionality due to a gradual reduction of the follicle in the ovary, determines menopause in women. Previous studies show that various factors may cause ovarian failure: chemotherapy, radiotherapy, idiopathic, genetic, and lifestyle habits such as smoking and consumption of harmful chemicals. According to Şükür et al. (2014), Ovarian aging represents unmet demand for infertility treatment.1 In the article, “Effect of seven oriental herbs mixture (Jogyeongbohyeoldan) on the restoration of ovarian aging in aged mice,” Joo et al. (2021) examined how Jogyeongbohyeoldan (JBD) affects ovarian aging and oocyte quality in aged and premature ovarian failure female mice.2 Additionally, the authors aimed to explore the impact of JBD on gene expression related to the activation of primordial cells, ovarian cells, and ovarian angiogenesis. While the study outlined encouraging results, the study findings cannot be considered significant due to the limitations regarding sample size and the duration of the study.
To conduct the study, the researchers performed three different experiments. JBD, which consists of seven herbal plants, was obtained from the Korean Medicine Hospital of Daejeon University. In the first experiment, Cisplatin was given to mice aged between 6-8 weeks for ten days while saline was injected to controls for the same number of days, and their body weights were measured daily. To establish the cell cytotoxicity of JBD, the researchers treated the cells using different JBD concentrations. To perform the second experiment, the mice were treated with JBD, then superovulated and bred with a male. The total zygotes and the embryo growth were then assessed. In the third experiment, the mice were treated with JBD and allowed to mate with males for two weeks. The researchers then monitored the pregnancy result for 20 days. The findings revealed that JBD administration increased fertility, ovarian role, and oocyte quality. Additionally, pregnancy outcome, the number of zygotes, and embryo development in premature ovarian failure and natural ovarian aging mice increased with JBD treatment but not in the control group.
Nonetheless, this study was limited by a small sample and a short study duration. First of all, the researchers sampled seven mice, which is a relatively small sample considering the general scope of the study. Besides, small sample sizes can affect the validity, accuracy, and reliability of the study outcome by exerting higher levels of margin error. Larger sample sizes can be used to provide more accurate findings. According to Boddy (2016), sample size influences the general outcome of the study.3 Thus, researchers should use a standard sample size for more apparent findings. Although Joo et al.’s findings outlined the significant increase in the number of pregnancy outcomes among the subjects, the results cannot be relied on for administering the seven oriental herbs mixture (Jogyeongbohyeoldan, JBD) treatment since there is not enough support to the findings. In addition, the sample size was too small to factor in the side effects and the possibility of errors associated with the medication. Therefore, it cannot be concluded that JBD treatment is efficient. Secondly, the researchers conducted their study within one month. Considering the nature of the study, the timeframe was too short to make general conclusions. A more extended period would allow examination for changes on the subjects, interfering with the JBD treatment procedure. A short time of study ignores errors that may occur and invalidation of the study outcomes. In this article, Joo et al. (2021) failed to validate the results due to time limitations. Thus, this limits their proposal for this research to contribute to developing a new treatment for ovarian aging. According to Arafat et al. (2016), every researcher should validate their findings to obtain more accurate results.4Yet, some researchers may have contrary opinions regarding the sample size. For example, Burmeiste et al. (2012) argue that sample size influences the study’s observations but does not affect the research findings.5 Nevertheless, Joo et al.’s (2021) findings were significantly limited in that the researcher could not determine the side effects of JBD treatment.
In conclusion, the researchers in this study did an excellent job in demonstrating that JBD can be used to treat ovarian aging. Nonetheless, the study findings were limited by sample size and the short study time. Using only seven mice to perform the experiment undermined the reliability of results, and the outcomes could not be generalized to the more prominent women population. Next, the short study duration limited the assessment of all possible effects of JBD treatment. Since no other researches have been previously conducted on this subject, further studies are needed to evaluate the beneficial components of JBD treatment on ovarian aging and the possible side effects. In addition, more studies should confirm whether JBD is an essential element in boosting the roles of the ovaries and increasing fertility in mice through withstanding ovarian aging.
- Şükür YE, Kıvançlı İB, Özmen B. Ovarian aging and premature ovarian failure. [Internet]. Journal of the Turkish German Gynecological Association. 2014 [Cited 2021 Nov 1]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4195330/
- Joo JK, Lim CH, Park MJ, Kim HJ, Kim CW, Yoon CH, Yoo JE, Joo BS. Effect of seven oriental herbs mixture (Jogyeongbohyeoldan) on the restoration of ovarian aging in aged mice. [Internet]. Clinical and Experimental Obstetrics & Gynecology. 2021 Feb 15. [Cited 2021 Nov 1]. Available at: https://ceog.imrpress.com/EN/Y2021/V48/I1/37
- Boddy CR. Sample size for qualitative research. Qualitative Market Research. [Internet]. An International Journal. 2016 Sep 12. [Cited 2021 Nov 1]. Available at: https://www.emerald.com/insight/content/doi/10.1108/qmr-06-2016-0053/full/html
- Arafat SY, Chowdhury HR, Qusar MM, Hafez MA. Cross-cultural adaptation & psychometric validation of research instruments: A methodological review. [Internet]. J Behav Health. 2016. [Cited 2021 Nov 1]. Available at: https://www.researchgate.net/profile/Sm-Arafat-2/post/Validity_Vs_Reliability/attachment/5aa68a774cde266d5890df03/AS%3A603360927436800%401520863863218/download/Review+Article.pdf
- Burmeister E, Aitken LM. Sample size: How many is enough? [Internet]. Australian Critical Care. 2012 Nov. [Cited 2021 Nov 1]. Available at: https://www.sciencedirect.com/science/article/pii/S1036731412000847