Antioxidants and Fertility in Women with Ovarian Aging: A Systematic Review and Meta-Analysis

IF 8 1区 医学 Q1 NUTRITION & DIETETICS
Yujie Shang , Nannan Song , Ruohan He , Minghua Wu
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Abstract

Ovarian aging is a major factor for female subfertility. Multiple antioxidants have been applied in different clinical scenarios, but their effects on fertility in women with ovarian aging are still unclear. To address this, a meta-analysis was performed to evaluate the effectiveness and safety of antioxidants on fertility in women with ovarian aging. A total of 20 randomized clinical trials with 2617 participants were included. The results showed that use of antioxidants not only significantly increased the number of retrieved oocytes and high-quality embryo rates but also reduced the dose of gonadotropin, contributing to higher clinical pregnancy rates. According to the subgroup analysis of different dose settings, better effects were more pronounced with lower doses; in terms of antioxidant types, coenzyme Q10 (CoQ10) tended to be more effective than melatonin, myo-inositol, and vitamins. When compared with placebo or no treatment, CoQ10 showed more advantages, whereas small improvements were observed with other drugs. In addition, based on subgroup analysis of CoQ10, the optimal treatment regimen of CoQ10 for improving pregnancy rate was 30 mg/d for 3 mo before the controlled ovarian stimulation cycle, and women with diminished ovarian reserve clearly benefited from CoQ10 treatment, especially those aged <35 y. Our study suggests that antioxidant consumption is an effective and safe complementary therapy for women with ovarian aging. Appropriate antioxidant treatment should be offered at a low dose according to the patient’s age and ovarian reserve.

This study was registered at PROSPERO as CRD42022359529.

抗氧化剂与卵巢衰老妇女的生育能力:系统回顾与元分析》(Antioxidants and Fertility in Women with Ovarian Ageing: a Systematic Review and Meta-Analysis)。
卵巢衰老是导致女性不孕的一个主要因素。多种抗氧化剂已被应用于不同的临床情况,但它们对卵巢衰老女性生育力的影响仍不明确。为此,我们进行了一项荟萃分析,以评估抗氧化剂对卵巢衰老女性生育的有效性和安全性。该研究共纳入了20项随机临床试验(RCT),共有2617人参与。结果表明,使用抗氧化剂不仅能显著增加取回的卵母细胞数量和优质胚胎率,还能减少促性腺激素的剂量,从而提高临床妊娠率。根据亚组分析,就不同剂量设置而言,低剂量效果更明显;就抗氧化剂类型而言,辅酶Q10(CoQ10)往往比褪黑素、肌醇和维生素更有效,因为与安慰剂或不治疗相比,辅酶Q10显示出更大优势,而其他药物则改善甚微。此外,根据辅酶Q10的亚组分析,辅酶Q10提高妊娠率的最佳治疗方案是在控制性卵巢刺激周期前三个月,每天30毫克,卵巢储备功能减退的妇女明显受益于辅酶Q10治疗,尤其是35岁以下的妇女。我们的研究表明,对于卵巢衰老的妇女来说,抗氧化剂是一种有效而安全的辅助疗法。应根据患者的年龄和卵巢储备功能,从低剂量开始提供适当的抗氧化剂治疗。本研究已在 PROSPERO 注册(CRD42022359529)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Advances in Nutrition
Advances in Nutrition 医学-营养学
CiteScore
17.40
自引率
2.20%
发文量
117
审稿时长
56 days
期刊介绍: Advances in Nutrition (AN/Adv Nutr) publishes focused reviews on pivotal findings and recent research across all domains relevant to nutritional scientists and biomedical researchers. This encompasses nutrition-related research spanning biochemical, molecular, and genetic studies using experimental animal models, domestic animals, and human subjects. The journal also emphasizes clinical nutrition, epidemiology and public health, and nutrition education. Review articles concentrate on recent progress rather than broad historical developments. In addition to review articles, AN includes Perspectives, Letters to the Editor, and supplements. Supplement proposals require pre-approval by the editor before submission. The journal features reports and position papers from the American Society for Nutrition, summaries of major government and foundation reports, and Nutrient Information briefs providing crucial details about dietary requirements, food sources, deficiencies, and other essential nutrient information. All submissions with scientific content undergo peer review by the Editors or their designees prior to acceptance for publication.
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