Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Pour Sina St, Tehran, 1416753955, Iran.
Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
J Ovarian Res. 2024 Aug 10;17(1):163. doi: 10.1186/s13048-024-01472-7.
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.
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.
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.
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.
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, I: 0%) and the total antioxidant capacity levels in the follicular fluid (MD: 0.04, 95% CI: 0.02 to 0.06, I: 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.
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.
氧化应激（OS）在女性生殖和生育能力中起着有害作用。多项研究探索了各种饮食干预和抗氧化补充剂，如虾青素（AST），以减轻 OS 对女性生育能力的不利影响。AST 对女性生育能力和生殖器官氧化还原状态的改善作用已在多项动物和临床研究中得到证实。
本系统评价和对动物及临床研究的荟萃分析的主要目的是全面概述 AST 对女性生育能力和生殖结局的影响的现有证据。AST 对生殖器官氧化还原状态、炎症和凋亡标志物的影响也被作为次要结局纳入。
我们系统地检索了电子数据库，包括 PubMed、Scopus 和 Web of Science，使用与 AST、女性生殖性能和不孕相关的特定搜索词，考虑到文献中用于比较口服 AST 补充剂与安慰剂或对照在人类或动物模型中的干预研究的不同同义词，检索时间截至 2024 年 1 月 1 日。
两名独立的审查员提取了研究特征、结局和偏倚风险的数据。我们使用随机效应模型汇总结果，并评估了异质性和证据质量。我们描述性地报告了来自动物模型的数据，因为无法进行荟萃分析。
临床试验的荟萃分析显示，AST 显著提高了卵母细胞成熟率（MD：8.40，95%CI：4.57 至 12.23，I：0%）和卵泡液中的总抗氧化能力水平（MD：0.04，95%CI：0.02 至 0.06，I：0%）。其他 ART 和妊娠结局以及氧化还原状态标志物没有显示出统计学上的显著变化。动物研究报告 AST 对氧化还原状态、炎症、凋亡和卵巢组织形态学有改善作用。
本系统评价表明，AST 补充剂通过提高卵子质量和降低生殖器官中的 OS，可能改善辅助生殖技术的结局。然而，由于纳入研究的异质性、偏倚风险和样本量小，证据有限。
