背景:氧化应激(OS)在女性生殖和生育能力中起着有害的作用。一些研究探索了各种饮食干预和抗氧化剂补充剂,如虾青素(AST),减轻OS对女性生育能力的不利影响。在一些动物和临床研究中已经显示了AST对女性生育力和生殖器官氧化还原状态的改善作用。
目的:目前对动物和临床研究的系统评价和荟萃分析的主要目的是全面概述目前关于AST对女性生育力和生殖结局的影响的证据。AST对氧化还原状态的影响,生殖器官炎症和凋亡标志物作为次要结局.
方法:我们系统地搜索了电子数据库,包括PubMed,Scopus,和WebofScience,直到2024年1月1日,使用与AST相关的指定搜索词,女性生殖性能,和不孕症,考虑到在人类或动物模型中比较口服AST补充剂与安慰剂或对照的介入研究的文献中发现的不同同义词。
方法:两名独立的评审员提取了有关研究特征的数据,结果,和偏见的风险。我们使用随机效应模型汇总了结果,并评估了异质性和证据质量。我们描述性地报告了动物模型的数据,因为meta分析是不可能的.
方法:临床试验的荟萃分析表明,AST可显著提高卵泡液中卵母细胞成熟率(MD:8.40,95%CI:4.57~12.23,I2:0%)和总抗氧化能力水平(MD:0.04,95%CI:0.02~0.06,I2:0%)。其他ART和妊娠结局和氧化还原状态标志物没有显示出统计学上的显着变化。动物研究报道了AST对氧化还原状态的改善作用,炎症,凋亡,和卵巢组织形态学。
结论:本系统综述显示,补充AST可以通过提高卵母细胞质量和降低生殖器官OS来改善辅助生殖技术的结果。然而,证据受到异质性的限制,偏见的风险,纳入研究的样本量较小。
BACKGROUND: Oxidative stress (OS) plays a harmful role in female reproduction and fertility. Several studies explored various dietary interventions and antioxidant supplements, such as astaxanthin (AST), to mitigate the adverse effects of OS on female fertility. Ameliorative effects of AST on female fertility and the redox status of reproductive organs have been shown in several animal and clinical studies.
OBJECTIVE: The main objective of present systematic review and meta-analysis of both animal and clinical studies was to provide a comprehensive overview of the current evidence on the effects of AST on female fertility and reproductive outcomes. The effect of AST on redox status, inflammatory and apoptotic markers in reproductive organs were included as the secondary outcomes.
METHODS: We systematically searched electronic databases including PubMed, Scopus, and Web of Science, until January 1, 2024, using specified search terms related to AST, female reproductive performance, and infertility, considering the diverse synonyms found in the literature for interventional studies that compared oral AST supplementation with placebo or control in human or animal models.
METHODS: Two independent reviewers extracted data on study characteristics, outcomes, and risk of bias. We pooled the results using random-effects models and assessed the heterogeneity and quality of evidence. We descriptively reported the data from animal models, as meta-analysis was not possible.
METHODS: The meta-analysis of clinical trials showed that AST significantly increased the oocyte maturation rate (MD: 8.40, 95% CI: 4.57 to 12.23, I2: 0%) and the total antioxidant capacity levels in the follicular fluid (MD: 0.04, 95% CI: 0.02 to 0.06, I2: 0%). The other ART and pregnancy outcomes and redox status markers did not show statistically significant changes. The animal studies reported ameliorative effects of AST on redox status, inflammation, apoptosis, and ovarian tissue histomorphology.
CONCLUSIONS: This systematic review shows that AST supplementation may improve assisted reproductive technology outcomes by enhancing oocyte quality and reducing OS in the reproductive organs. However, the evidence is limited by the heterogeneity, risk of bias, and small sample size of the included studies.