A very large scientific review was recently published, analyzing the results from over 50 scientific research trials evaluating for the use of antioxidants for the treatment of infertility.
The use of antioxidants for fertility is an important topic of research as oxidative stress has been postulated as a mechanism for infertility. Oxidative stress may be elevated in particular in Women with polycystic ovarian syndrome, endometriosis, dilated Fallopian tubes, and possible unexplained infertility.
How Does Oxidative Stress Harm Fertility?
Oxidative stress can damage cellular membranes by causing a chemical process called lipid peroxidation, it may cause damage to protein structures in cells, damage DNA, and can therefore negatively affect oocyte (egg) quality and implantation.
How do Certain Antioxidants Work?
Aside from being antioxidant in nature, various antioxidants can have other physiological effects in the body that may be able to support fertility. For example, Vitamin e may support growth of blood vessels and endometrium, Vitamin D can help increase pregnancy rates by modulating anti-mullerian hormone (AMH) levels, N-Acetyl-Cysteine can help support production of fertile cervical mucus, Omega 3's can reduce inflammation, and arginine can help improve blood flow to the uterus and ovaries. In addition to these functions, they can help reduce oxidative stress in the body and therefore prevent free radicals from damaging immature eggs and endometrial tissue.
What was the Measured Improvement in Fertility?
The Live Birth Rate (percentage of Women who deliver a live and healthy baby) for an average Woman with subfertility is about 20%, the use of antioxidants may increase this rate to 26-43%
The Clinical Pregnancy Rate (percentage of Women who receive a positive pregnancy test and confirm pregnancy with a fetal heartbeat) is about 22% for sub-fertile Women. The use of antioxidants may increase this to 27-33%.
Treatment Duration:
The Women in the studies were using the antioxidant treatments anywhere from 2.5 to 6 months in duration.
Which Antioxidants Worked Best?
Single antioxidants did not work well unless used in combination. Combined antioxidant treatments that included multiple antioxidants seemed to have the beneficial effects on fertility. The only antioxidant that appeared to improve pregnancy rates on its own without combining it with other antioxidants was Coenzyme Q10.
Limitations of the Studies analyzed:
The quality of the studies was deemed "low" to "very-low" as the studies failed to report various parameters and were at risk for selection bias. However, the evidence that was available does point towards a possible improvement in fertility, especially in Women with polycystic ovarian syndrome (PCOS).
Adverse Effects from Treatments:
Not enough scientific data was available to accurately determine a cause and effect relationship between various antioxidants and side effects. However, some studies reported cases of headaches, upset stomach, and ectopic pregnancy.
While more studies are needed to accurately determine the extent to which antioxidants may play a role in improving fertility, for now it appears that there may be a role for these treatments for Women experiencing infertility.
This article is in no way a replacement for medical advice or medical care, it is advised that anyone concerned about their Health should speak with their Naturopathic Doctor or Primary Care Provider.
References:
1. Showell, M. G., Mackenzie-Proctor, R., Jordan, V., & Hart, R. J. (2017). Antioxidants for female subfertility. Cochrane Database of Systematic Reviews..