Longevity and Reproductive Aging Reproductive Aging

Antioxidants reduce oxidative stress in follicular fluid of aged women undergoing IVF

Luddi A, Capaldo A, Focarelli R, Gori M, Morgante G, Piomboni P, De Leo V

Published September 7, 2016 Reproductive biology and endocrinology : RB&E
DOI 10.1186/s12958-016-0184-7 PMID 27604261 PMC PMC5015196

RRM Academy Synopsis

Supplement may lower follicle oxidative stress in IVF patients over 39

In 18 IVF patients over 39, follicle fluid showed less oxidative damage on a vitamin and mineral supplement, a preliminary study found. Each woman had one cycle without it and a second after three months on it. Unsuitable eggs fell, but mature eggs, fertilization and embryo grades didn't differ.

Key Findings

  • In the 18 women, total antioxidant capacity rose significantly in both follicle fluid and blood serum in the supplemented cycle (P < 0.05).
  • Proteins in follicle fluid and serum carried more free thiol groups, a sign of less oxidative damage, after supplementation (p < 0.05).
  • Eggs judged unsuitable for injection fell from a mean of 1.88 in the first cycle to 1.20 in the supplemented cycle (P = 0.01).
  • Eggs retrieved (6.76 vs 6.37), mature eggs (5.14 vs 4.07), fertilization and cleavage rates, and embryo grades didn't differ significantly.

Interpretation

Each of the 18 women was compared with herself across two IVF cycles within a 9- to 12-month period, and the supplement came in the second cycle each time. The study had no randomization, no placebo and no separate control group. The fluid tested was collected at egg retrieval, after hormone stimulation. The abstract reports more good-quality eggs; the table shows fewer unsuitable eggs and no significant change in mature eggs. Male factor infertility was the reason given for 8 of the 18 couples.

RRM Context

RRM examines egg health within a woman's own ovulatory cycle. It evaluates both partners for why conception isn't happening, and oxidative stress and nutrition belong to that search for root causes. The markers here came only from stimulated IVF cycles, so they describe the follicle in that setting.

Abstract

Background

The status characterized by the imbalance between pro-oxidants and antioxidants molecules, defined as oxidative stress, has been suggested to be involved in the pathogenesis of subfertility in females. This study aims to evaluate the impact of a complete micronutrients supplementation on oxidative stress levels in follicular microenvironment as well as on in vitro fertilization (IVF) outcome.

Methods

This preliminary study was conducted between January 2014 and July 2015 at the Siena University Hospital Infertility Clinic. Serum and follicular fluid were collected from infertile women aged > 39 years who underwent two in vitro fertilization cycles: in the first cycle they were treated with GnRH-antagonist protocol and gonadotropins for controlled ovarian hyperstimulation, whereas in the second cycle ovarian stimulation protocol was associated to micronutrients supplementation, starting three months earlier. Protein oxidation levels and total antioxidant capacity in serum and in follicular fluid were evaluated in IVF cycles with or without micronutrients supplementation. Differences in IVF outcome parameters were statistically evaluated.

Results

Two-dimensional electrophoresis analyses demonstrated that when patients assumed micronutrients before IVF cycles, follicular fluid and serum proteins were protected from oxidative damage. Comparable results were obtained when total antioxidant capacity was measured. Moreover, the mean number of good quality oocytes retrieved when patients received micronutrients supplementation was significantly increased.

Conclusion

The additional treatment with micronutrients, starting three months before IVF cycles, protects the follicular microenvironment from oxidative stress, thus increasing the number of good quality oocytes recovered at the pick up.

Topics

By this author

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Longevity and Reproductive Aging › Reproductive Aging › Ovarian Aging · Lifestyle and Environment › Nutrition and Metabolic Health › Micronutrients and Supplements · Therapeutics › Supplements and Botanicals › Antioxidant Supplements
Alice Luddi, Angela Capaldo, Riccardo Focarelli, Martina Gori, Giuseppe Morgante, Paola Piomboni, Vincenzo De Leo
A Luddi, A Capaldo, R Focarelli, M Gori, G Morgante, P Piomboni, V Leo
PMID 27604261 27604261 DOI 10.1186/s12958-016-0184-7 10.1186/s12958-016-0184-7 Luddi et al. 2016, Luddi 2016