Table 3 Study outcomes involving oral supplementation of various antioxidants in women
From: Utility of antioxidants during assisted reproductive techniques: an evidence based review
Antioxidant | Study type | Patient population | Intervention (daily dose x duration) | Control group (daily dose) | Study outcome | Reference |
|---|---|---|---|---|---|---|
Vitamin E | Â | Women with unexplained infertility undergoing ovarian stimulation and then IUI | 400Â IU/day vitamin E | Â | 1. Increased endometrial thickness | Cicek et al. [122] |
2. No significant increase in implantation and pregnancy rates | ||||||
Vitamin C | Prospective | Women undergoing IVF-ET (n = 76) | 500 mg vitamin C/day (slow release) to women smokers (n = 19) and women non-smokers (n = 19) | Placebo | Women non-smokers had higher pregnancy rates than women smokers | Crha et al. [123] |
Vitamin C | Prospective, randomized | Infertile women with luteal phase defects (not on IVF-ET) | 750 mg ascorbic acid (n = 76) started on first day of third menstrual cycle until positive urine pregnancy test (maximum 6 months) | No treatment (n = 46) | 1. Increase in progesterone levels | Henmi et al. [124] |
2. Increase in clinical pregnancy rates | ||||||
Vitamin C | Double blind, placebo-controlled, RCT | Women (<40y) undergoing first IVF-ET cycles (n = 620) | 1 g or 5 g or 10 g ascorbic acid +30 mg Dydrogesteron x 14 days after follicle aspiration for IVF-ET | Placebo (Lactose + citric acid +30 mg Dydrogesteron) | No difference in clinical pregnancy and implantation rates | Griesinger et al. [125] |
Myo-inositol + folic acid | Placebo-controlled, RCT | Infertile PCOS patients undergoing ovulation induction for ICSI (n = 60) | 4 g myo-inositol +400 μg folic acid (n = 30) | 400 μg folic acid only (n = 30) | Reduced germinal vesicles and degenerated oocytes without compromising the number of oocytes retrieved at ovum pick-up | Papaleo et al. [126] |
Myo-inositol + folic acid | Double blind | Infertile PCOS patients undergoing ovulation induction for IVF or ICSI (n = 34) | 4 g of myo-inositol +400 μg of folic acid, continuously for 3 months | 400 μg of folic acid only | 1. Greater number of oocytes recovered during pick up | Ciotta et al. [127] |
2. Greater number of oocytes with score S1 | ||||||
3. Reduced number of immature oocytes (vesicles germ and degenerated oocytes) | ||||||
Melatonin | Follicular fluid sampled during oocyte retrieval during IVF-ET | Women with prior failure of IVF-ET cycle and who are attempting IVF-ET again (n = 115) | 3 mg melatonin (n = 56) given on the 5th day of the previous menstrual cycle until the day of oocyte retrieval | Without melatonin treatment (n = 59) | 1. Improved fertilization rate compared to previous IVF-ET cycle | Tamura et al. [128] |
2. Improved oocyte quality | ||||||
Melatonin | Prospective, randomized | Women with primary infertility undergoing IVF-ET cycles (n = 85) | 3 mg melatonin (n = 40) administered continuously from day of GnRH | No treatment (n = 45) | 1. Higher percentage of morphologically mature oocytes retrieved (MII oocytes) | Batioglu et al. [129] |
2. Higher mean number of top quality (class I) embryos | ||||||
3. No improvement in fertilization rates | ||||||
4. Higher tendency of clinical pregnancy rate (not statistically significant) | ||||||
Melatonin | Prospective, randomized | IVF patients with disturbed sleep (insomnia) who were undergoing IVF-ET (n = 60) | 3 g melatonin (n = 30) given 3rd to the 5th day of the previous menstrual cycle until the hCG injection day of the controlled ovarian hyperstimulation | No treatment (n = 30) | 1. Higher mean number of the retrieved oocytes, mean MII oocyte counts, and G1 embryo ratio | Eryilmaz et al. [130] |
2. No change in sleeping status | ||||||
Melatonin + myo-inositol + folic acid | Prospective, randomized | Women undergoing IVF cycles (n = 65) | 3 g melatonin +4 g myo-inositol +200 mg folic acid (n = 32) administered continuously from day of GnRH | 4 g myo-inositol + folic acid (n = 33) | 1. Greater mean number of mature oocytes (and lower mean number of immature oocytes) | Rizzo et al. [131] |
2. Higher mean number of top quality embryos (class 1 and 2) | ||||||
3. No improvement in fertilization rates | ||||||
4. Higher tendency of clinical pregnancy rate and implantation rate (not statistically significant) | ||||||
Melatonin + myo-inositol + folic acid | Prospective, longitudinal, cohort | Women with failed IVF cycle (due to poor oocyte quality) who were undergoing a new IVF cycle | 3 mg melatonin +4 g myo-inositol +400 mcg folic acid x 3 months (n = 46) | Prior cycle of the same women but without treatment | 1. Higher number of morphologically mature oocytes retrieved (MII oocytes) | Unfer et al. [132] |
2. Higher total number of embryo transferred and higher number of top quality (score 1 & 2) embryo transferred | ||||||
3. Increased fertilization rate |