Fatemi Farnaz, Mohammadzadeh Afsaneh, Sadeghi Mohammad Reza, Akhondi Mohammad Mehdi, Mohammadmoradi Shayan, Kamali Koorosh, Lackpour Nicknam, Jouhari Sheida, Zafadoust Simin, Mokhtar Sara, Giahi Ladan
Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
Clin Nutr ESPEN. 2017 Apr;18:23-30. doi: 10.1016/j.clnesp.2017.01.002. Epub 2017 Jan 27.
BACKGROUND & AIMS: Ovulation induction has been proven to impose oxidative stress during ICSI treatment cycle. Also, data indicates that PCOS women show higher oxidative markers. Available data are not convincing about which antioxidant supplements have the potential to overcome oxidative stress in PCOS subjects. The aim of this trial was to investigate the possible role of combined vitamin E and D supplementation in the ICSI outcomes (oocyte number and quality, embryo number and quality, pregnancy rate) of PCOS subjects.
A total of 105 PCOS infertile women scheduled for ICSI were enrolled in a double-blinded RCT to treatment group (vitamin E, 400 mg/day - and vitamin D, 50,000 IU/one in two weeks, n = 52) or placebo group (n = 53) for 8 weeks. The primary outcomes were implantation rate, pregnancy and clinical pregnancy rate. Secondary outcomes included oocyte quality, embryo quality, fertilization rate, alteration in serum MDA, TAC and vitamin D after treatment. Further, association between serum and follicular fluid Malondialdehyde (MDA), Total Antioxidant Capacity (TAC), and serum vitamin D level were assessed.
Pregnancy, clinical pregnancy and implantation rate were significantly higher in treatment group (P < 0.001). Data analysis in both groups revealed a significant increase in serum MDA compared to baseline and a significant decrease in serum TAC compared to baseline after treatment. Further analysis showed that there is a positive weak association between vitamin D level, implantation rate (P = 0.015) and increased clinical pregnancy (P = 0.037). No significant association was detected between either follicular fluid or serum MDA and TAC and ICSI outcomes.
In conclusion, the findings of this trial do not add clinical support to the evidence that vitamins E and D may play a role in the success rate of IVF via an antioxidant mechanism.
IRCT2014081018662N1.
促排卵已被证实在卵胞浆内单精子注射（ICSI）治疗周期中会产生氧化应激。此外，数据表明多囊卵巢综合征（PCOS）女性表现出更高的氧化标志物水平。关于哪种抗氧化剂补充剂有可能克服PCOS患者的氧化应激，现有数据并不令人信服。本试验的目的是研究联合补充维生素E和D对PCOS患者ICSI治疗结局（卵子数量和质量、胚胎数量和质量、妊娠率）的可能作用。
总共105名计划接受ICSI的PCOS不孕女性被纳入一项双盲随机对照试验，分为治疗组（维生素E，400毫克/天 - 维生素D，50000国际单位/每两周一次，n = 52）或安慰剂组（n = 53），为期8周。主要结局为着床率、妊娠率和临床妊娠率。次要结局包括卵子质量、胚胎质量、受精率、治疗后血清丙二醛（MDA）、总抗氧化能力（TAC）和维生素D的变化。此外，评估了血清和卵泡液中丙二醛（MDA）、总抗氧化能力（TAC）与血清维生素D水平之间的关联。
治疗组的妊娠率、临床妊娠率和着床率显著更高（P < 0.001）。两组的数据分析均显示，与基线相比，治疗后血清MDA显著增加，血清TAC显著降低。进一步分析表明，维生素D水平与着床率（P = 0.015）和临床妊娠率增加（P = 0.037）之间存在弱正相关。在卵泡液或血清MDA与TAC以及ICSI治疗结局之间未检测到显著关联。
总之，本试验的结果并未为维生素E和D可能通过抗氧化机制影响体外受精成功率的证据提供临床支持。
IRCT2014081018662N1
