PDF(Pubmed)
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.
摘要：
卵巢老化是女性不孕的主要因素。多种抗氧化剂已应用于不同的临床场景，但它们对卵巢老化女性生育能力的影响尚不清楚。为了解决这个问题，本研究进行了一项荟萃分析,以评估抗氧化剂对卵巢老化女性生育的有效性和安全性.共纳入20项随机临床试验（RCT），有2617名参与者。结果表明，使用抗氧化剂不仅显着增加了回收的卵母细胞数量和高质量的胚胎率，而且减少了促性腺激素的剂量，有助于提高临床妊娠率。根据亚组分析,关于不同的剂量设置，较低剂量的效果更明显；就抗氧化剂类型而言，辅酶Q10（CoQ10）往往比褪黑激素更有效，肌醇和维生素，因为与安慰剂或不治疗相比，辅酶Q10表现出更多的优势，而在其他药物中观察到小的改善。此外,根据CoQ10的亚组分析，CoQ10改善妊娠率的最佳治疗方案是在控制性促排卵周期前三个月30mg/d，卵巢储备减少的女性明显受益于辅酶Q10治疗，尤其是35岁以下的人。我们的研究表明，抗氧化剂是卵巢衰老女性的有效和安全的补充疗法。应根据患者年龄和卵巢储备，从低剂量提供适当的抗氧化治疗。本研究在PROSPERO注册(CRD42022359529)。
