Preconception becomes very important because, at this time, women will prepare themselves before conception occurs. Thus, the fulfillment of nutrition and the mother's psychological condition must be good for giving birth to healthy offspring.1 Fulfillment of good nutrition during the preconception can reduce the risk of complications at the time of conception that will affect the health of the offspring.2 Besides, the state of stress that occurs in women during this preconception also greatly affects the mother's health, which will cause menstrual disorders, PCOS (Polycystic Ovarian Syndrome), and infertility.3 Oxidative stress is a form of stress that occurs due to the body's lack of antioxidants and high free radicals that will cause damage to the cells.4

Management of oxidative stress that occurs in preconceived women can be done with non-pharmacological therapy, one of which is royal jelly. Royal jelly is another product of bees produced by thick white bees such as milk secreted from the hypopharyngeal gland and mandibular worker bees as food from the queen bee.5 Royal jelly is often referred to as a superfood because it contains complex nutrients, namely fat, water, carbohydrates, protein, amino acids, sugar, iron, calcium, and vitamins. Additionally, royal jelly also contains flavonoids and phenolic acids, which are part of phenolic as an antioxidant.6,7 The complexity of the nutrition content of royal jelly provides pharmacological effects such as antibacterial, anti-tumor, anti-allergic, and anti-inflammatory.8

Several studies have been conducted in discussing the chemical structure, content, bioactivity, and antioxidant examination of royal jelly, which can be used as scientific information on the benefits of royal jelly. However, the explanation of the benefits of the information of the royal jelly as a non-pharmacological therapy in preconception women who experience stress is still very minimal. Thus, this literature review aims to provide information about the effect and benefit of royal jelly against oxidative stress in preconception women.

In searching journals in this literature review, using online libraries to look for journals relevant to the content and benefits of royal jelly in overcoming the stress on preconception women in this literature, namely PubMed, ContentSciendo, and ScienceDirect. In the search for related articles based on keywords in questions in the study. Search keywords consist of; royal jelly, stress, oxidative stress, preconception.

The search for articles that have been done by filtering according to research keywords in the last 5 years acquired 25 articles related to the content of royal jelly and oxidative activity. Then do the filtering of the articles again related to the questions in this study so that 6 articles are appropriate.

• 1.

  The main content of royal jelly

  Based on Table 1, royal jelly contains 50–70% water, 7–18% carbohydrate, 9–18% protein, 3–8% lipids, 1.5% mineral salts, polyphenols, enzymes, hormones, and vitamins. Royal jelly contains bioactive components consisting of peptides, sterols, and fatty acids such as 10-hydroxy-2-decanoic, which effectively reduce ROS (reactive oxygen species) and hydroxyl radicals.9

  Table 1.

  Mineral and vitamin content of royal jelly.7,10

  Minerals and vitamins	(mg/100g)
  Potassium	200–1000
  Magnesium	20–100
  Iron	1–11
  Zink	0.7–8
  Copper	0.33–1.6
  B1 (thiamin)	0.1–1.7
  B2 (riboflavin)	0.5–2.5
  B3 (niacin)	4.5–19
  B5 (panthothenic acid)	3.6–23
  B6 (pyridoxin)	0.2–5.5
  H (BIOTIN)	0.15–0.55
  Folic acid	0.01–0.06
• 2.

  Antioxidant in royal jelly

  Flavonoid is a form of antioxidant in the royal jelly, divided into flavonoids, flavon, flavonol, and dan isoflavonoid.7 The royal jelly contains 23.3±0.92GAEμg/mg total of phenolics and 1.28±0.09REμg/mg of total flavonoid.6 Pinobanksin and organic acids and their esters, for example, octanoic acid, 2-hexanoic acid, their esters, dodecanoic acid, and their esters, 1,2-benzene dicarboxylic acid, and benzoic acid are the main phenolic compounds contained in royal jelly.11

• 3.

  Royal jelly in dealing with oxidative stress in preconception women

The antioxidant content of royal jelly can overcome oxidative stress due to high free radicals in preconception women. In some studies, royal jelly provides significant protection against the liver and kidneys by reducing lipid peroxidation and increasing glutathione (GSH) as an antioxidant.12 Royal jelly also contains a bioactive component in the form of 10-hydroxy-2-decanoic (10-HDA), which is an anti-inflammatory and can reduce oxidative stress.13 Also, royal jelly can increase the growth and development of follicles that secrete estradiol to stimulate the uterus, increase LH (luteinizing hormone) and ovulation.14,15 Royal jelly contains MRJP 1, which gives a hypercholesterolemia effect that will affect the inhibition of corticosterone synthesis.16

The six journal articles in Table 2 explained that giving royal jelly as a supplement can have a significant effect in increasing antioxidant levels to reduce oxidative stress that occurs during preconception.19 Antioxidants usually inhibit ROS production (reactive oxygen species) and bind to free radicals so that they become reactive.14 The antioxidant effect contained in the royal jelly can maintain the increase in glutathione in the blood, which is the primary antioxidant that functions as a detoxifier and regulates the immune system.20 Glutathione is produced from cells directly involved in neutralizing ROS free radicals and maintaining reduced vitamin C and E as exogenous antioxidants.18 In other studies, administering royal jelly with certain doses can increase antioxidants in the FRAP (ferric reducing antioxidant power) test and reduce nitric oxidase levels, which can reduce ROS increase by decreasing nitric oxidase levels.12 Besides, an antioxidant activity that maintains elevated levels of glutathione in royal jelly can reduce the increase in lipid peroxidation, which is a sign of oxidative stress.17

Based on a journal search, using royal jelly as a supplement to increase antioxidants in the body in overcoming oxidative stress that occurs in preconception women is very effective. Several laboratory tests have been done to state that royal jelly given to animals increases glutathione levels as the main antioxidant in the body and can suppress increased lipid peroxidation, reducing oxidative stress.

The authors declare no conflict of interest.