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For example, melatonins restoration of glycolysis and TCA cycle activity in HGL5 granulosa cells suggests that women with metabolic dysregulation in cumulus-oocyte complexes may require higher doses ( 4.4 Challenges and future directions Although significant progress has been made, key challenges remain, including genetic heterogeneity such as MTHFR variants complicating folate dosing, limited clinical validation of oxidative stress biomarkers for infertility, and reliance on animal models, highlighting the need for human RCTs with stratified cohorts ( 5 Limitations of current evidence and recommendations for future research The following section discusses the key limitations of existing studies on dietary interventions and oocyte quality, as well as actionable recommendations to address these gaps and advance future research