Antioxidants for female subfertility

Antioxidants might possibly be effective for improving birth rate in subfertile women compared with placebo or no treatment, but the evidence is limited.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment and unclear blinding in half othe studies, and selective reporting), by imprecise results (few patients and events for one comparison), and by inconsistency (unexplained variability in results).

Summary

A Cochrane review included 50 studies with a total of 6 510 subjects. Oral antioxidants, including combinations of antioxidants, pentoxifylline, N-acetyl-cysteine, melatonin, L-arginine, vitamin E, myo-inositol, vitamin C, vitamin D+calcium and omega-3-polyunsaturated fatty acids were compared with placebo, with no treatment/standard treatment or another antioxidant. Antioxidants were associated with an increased live birth rate and clinical pregnancy rate compared with placebo or no treatment/standard treatment . This suggests that among subfertile women with an expected live birth rate of 20%, the rate among women taking antioxidants would be between 26% and 43%. Pentoxifylline was associated with an increased clinical pregnancy rate compared with placebo or no treatment (OR 2.03, 95% CI 1.19 to 3.44, P = 0.009; 3 RCTs, n=276, I²= 0%) but in one study there was no difference in live birth (OR 1.54, 95% CI 0.68 to 3.50, n=112).

Date of latest search: 2018-01-22

Ədəbiyyat

1. Showell MG, Mackenzie-Proctor R, Jordan V et al. Antioxidants for female subfertility. Cochrane Database Syst Rev 2017;(7):CD007807.