Hosseini Fatemeh Sadat, Shamsipour Mansour, Yazdekhasti Hossein, Akbari-Asbagh Firoozeh, Shahraki Zahra, Aghaee-Bakhtiari Seyed Hamid
School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Naunyn Schmiedebergs Arch Pharmacol. 2021 Jul;394(7):1487-1495. doi: 10.1007/s00210-021-02071-9. Epub 2021 Mar 8.
This study aims to evaluate the effect of melatonin supplementation on the outcomes of in vitro fertilization (IVF) and mitochondrial adenosine triphosphate production (MT-ATP6) gene expression in Iranian infertile couples. A single-blind nonrandomized controlled trial was conducted, recruiting 90 infertile couples who underwent IVF at an infertility center in Tehran, Iran. Patients who were assigned to the intervention group received melatonin as a supplementation to the standard controlled ovarian stimulation (COS). The control group received a COS protocol only. Primary outcome was the mRNA level of the MT-ATP6 gene in cumulus cells of ovarian follicles. Secondary outcomes were the mean number of mature oocytes retrieved, the embryo quality, and biochemical and clinical pregnancy rates. The mRNA level of the MT-ATP6 gene in cumulus cells between intervention and control groups was not statistically different (0.931 vs.1; P ˃ 0.05). The mean number of poor-quality embryos was significantly lower in the intervention group than that in the control group (0.27 vs. 0.80; P = 0.028). The biochemical and clinical pregnancy rates were higher in the intervention group (24% vs. 14%, P = 0.089, and 14% vs. 7%, P = 0.302, respectively); however, the difference was not significant. Melatonin supplementation did not increase the odds of clinical pregnancy and the number of mature oocytes retrieved, but significantly reduced the number of low-quality embryos. More extensive studies focusing on the level of MT-ATP6 gene expression in the oocyte or blastomere cells may further elucidate the effect of supplementation with melatonin in infertile couples who have poor clinical outcomes. Trial registration: Current Controlled Trials: IRCT2015042912307N4.
本研究旨在评估补充褪黑素对伊朗不孕夫妇体外受精（IVF）结局及线粒体三磷酸腺苷生成（MT-ATP6）基因表达的影响。开展了一项单盲非随机对照试验，招募了90对在伊朗德黑兰一家不孕不育中心接受IVF的不孕夫妇。被分配到干预组的患者在标准控制性卵巢刺激（COS）基础上接受褪黑素补充治疗。对照组仅接受COS方案。主要结局是卵巢卵泡卵丘细胞中MT-ATP6基因的mRNA水平。次要结局是回收的成熟卵母细胞平均数量、胚胎质量以及生化妊娠率和临床妊娠率。干预组和对照组卵丘细胞中MT-ATP6基因的mRNA水平无统计学差异（0.931对1；P＞0.05）。干预组中质量差的胚胎平均数量显著低于对照组（0.27对0.80；P = 0.028）。干预组的生化妊娠率和临床妊娠率更高（分别为24%对14%，P = 0.089，以及14%对7%，P = 0.302）；然而，差异不显著。补充褪黑素并未增加临床妊娠几率和回收的成熟卵母细胞数量，但显著减少了低质量胚胎的数量。针对卵母细胞或卵裂球细胞中MT-ATP6基因表达水平开展更广泛的研究，可能会进一步阐明补充褪黑素对临床结局不佳的不孕夫妇的影响。试验注册：当前受控试验：IRCT2015042912307N4。
