Does melatonin treatment improve fertility outcomes in assisted reproduction?

In a nutshell

This study investigated if melatonin improves fertility outcomes in assisted reproduction (AR).

They found that melatonin improved the clinical pregnancy rate (CPR) in AR cycles. 

Some background

Infertility is becoming increasingly common. Assisted reproduction (AR) can be used to treat infertility. Many studies have been conducted to improve fertility outcomes in AR cycles. One area of interest is oxidative stress (OS). OS is caused by free oxygen atoms. These are called free radicals (FRs). They can cause stress to cells and damage them. This includes sperm cells and oocytes (eggs). Some experts suggest that reducing OS could improve fertility outcomes in AR. 

Melatonin is a hormone. It is naturally produced by the body. It regulates the sleep cycle. Melatonin also protects from OS. Melatonin can also find and eliminate FRs. This reduces OS. It is unclear if melatonin treatment improves fertility outcomes in AR cycles.

Methods & findings

This study included 10 clinical trials with melatonin. 1,203 women undergoing AR were analyzed. Women were randomly assigned to melatonin or a placebo (inactive tablet) treatment. 9 studies involved taking melatonin supplements. 1 study involved treating embryos with melatonin during AR. Fertility outcomes included clinical pregnancy rate (CPR) and live birth rate (LBR). 

CPR was significantly increased by 43% in the melatonin group. However, LBR was not significantly improved by melatonin treatment (increased slightly by 38%). The number of oocytes retrieved was 66% higher in melatonin-treated patients. The number of good quality embryos was also significantly higher (by 64%) in the melatonin group. Melatonin did not have a significant effect on miscarriage rates. 

Methods & findings
The bottom line

The authors concluded that melatonin improved the CPR in AR cycles.

The fine print

Patients were treated with different doses of melatonin in the studies. Also, most of the studies analyzed were considered of low quality. A larger controlled study is needed to confirm these findings.

What’s next?

If you have any concerns regarding infertility please consult with your physician.

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Published By: Frontiers in Endocrinology
Date: Nov 11, 2020
Original Title: Melatonin Application in Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Randomized Trials.

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