Antioxidants and Fertility in Women with Ovarian Aging: A Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 39019217 · doi:10.1016/j.advnut.2024.100273
What was done
A systematic review and meta-analysis of 20 randomized clinical trials comprising 2,617 participants was performed to evaluate the efficacy and safety of antioxidants on fertility outcomes in women with ovarian aging (registered in PROSPERO as CRD42022359529). The authors analyzed outcomes across different antioxidant types (CoQ10, melatonin, myo-inositol, vitamins), dosages, and patient demographics.
What was found
Antioxidant use significantly increased the number of retrieved oocytes and high-quality embryo rates, reduced gonadotropin dosage requirements, and increased clinical pregnancy rates (specific effect sizes and confidence intervals were not reported in the abstract). Lower doses demonstrated greater efficacy. CoQ10 showed superior benefits compared to melatonin, myo-inositol, and vitamins versus control. Subgroup analysis identified an optimal CoQ10 regimen of 30 mg/day for 3 months prior to controlled ovarian stimulation, with pronounced benefits in women aged <35 years with diminished ovarian reserve.
Why it matters
This meta-analysis provides consolidated evidence supporting low-dose antioxidant pre-treatment—especially CoQ10—to enhance assisted reproduction outcomes in patients with diminished ovarian reserve.
Limits
The abstract reports no numerical effect sizes, confidence intervals, or heterogeneity metrics. Live birth rate, the definitive clinical outcome in reproductive medicine, was not reported in the abstract. Interventions, control arms, and definitions of ovarian aging varied across included trials.