Antioxidants for female subfertility

Showell, Marian G; Mackenzie-Proctor, Rebecca; Jordan, Vanessa; Hart, Roger J

doi:10.1002/14651858.cd007807.pub4

Cited by 119Reproductive Health and TechnologiesReproductive Biology and FertilityOvarian function and disorders

Antioxidants for female subfertility

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Showell, Marian G, Mackenzie-Proctor, Rebecca, Jordan, Vanessa, Hart, Roger J·2020·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd007807.pub4

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Abstract

BackgroundA couple may be considered to have fertility problems if they have been trying to conceive for over a year with no success.This may affect up to a quarter of all couples planning a child.It is estimated that for 40% to 50% of couples, subfertility may result from factors affecting women.Antioxidants are thought to reduce the oxidative stress brought on by these conditions.Currently, limited evidence suggests that antioxidants improve fertility, and trials have explored this area with varied results.This review assesses the evidence for the effectiveness of different antioxidants in female subfertility. ObjectivesTo determine whether supplementary oral antioxidants compared with placebo, no treatment/standard treatment or another antioxidant improve fertility outcomes for subfertile women. Search methodsWe searched the following databases (from their inception to September 2019), with no language or date restriction: Cochrane Gynaecology and Fertility Group (CGFG) specialised register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL and AMED.We checked reference lists of relevant studies and searched the trial registers. Selection criteriaWe included randomised controlled trials (RCTs) that compared any type, dose or combination of oral antioxidant supplement with placebo, no treatment or treatment with another antioxidant, among women attending a reproductive clinic.We excluded trials comparing antioxidants with fertility drugs alone and trials that only included fertile women attending a fertility clinic because of male partner infertility. Data collection and analysisWe used standard methodological procedures expected by Cochrane.The primary review outcome was live birth; secondary outcomes included clinical pregnancy rates and adverse events. Main resultsWe included 63 trials involving 7760 women.Investigators compared oral antioxidants, including: combinations of antioxidants, Nacetylcysteine, melatonin, L-arginine, myo-inositol, carnitine, selenium, vitamin E, vitamin B complex, vitamin C, vitamin D+calcium, CoQ10, and omega-3-polyunsaturated fatty acids versus placebo, no treatment/standard treatment or another antioxidant.Only 27 of the 63 included trials reported funding sources. Antioxidants for female subfertility (Review)

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Low-to very low-quality evidence suggests that antioxidant supplementation in women with infertility may increase pregnancy or live birth rates.
“Low-to very low-quality evidence suggests that antioxidant supplementation in women with infertility may increase the chance of pregnancy or live birth rate (Showell 2020).”
From Preconception lifestyle advice for people with infertility (2021) · cites this paper as Showell 2020

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PP-007 - Follicular fluid homocysteine with acetyl cysteine supplemented ovarian stimulation: correlation with oocyte yield and ICSI cycle outcome
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FOLLICULAR FLUID HOMOCYSTEINE WITH ACETYL CYSTEINE SUPPLEMENTED OVARIAN STIMULATION: CORRELATION WITH OOCYTE YIELD AND ICSI CYCLE OUTCOME.
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Effect of N-acetyl cysteine on expression of oxidation-reduction genes during implantation window in Recurrent Implantation Failure: a double blinded randomized placebo controlled trial, phase II
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Pretreatment with coenzyme Q10 improves ovarian response and embryo quality in low-prognosis young women with decreased ovarian reserve: a randomized controlled prospective study
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Self-citation
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RETRACTED ARTICLE: Melatonin levels and embryo quality in IVF patients with diminished ovarian reserve: a comparative study
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Antioxidants in fertility: impact on male and female reproductive outcomes
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Efficacy of combined antioxidant therapy in male subfertility-A systematic review and meta-analysis
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The efficacy of antioxidants for female subfertility
Khalil, H. (2013) · Australian pharmacist

Authors: Showell, M. G., Mackenzie-Proctor, R., Jordan, V., & Hart, R. J.
Affiliations: University of Auckland (NZ)
Auckland City Hospital (NZ)
The University of Western Australia (AU)
ORCID: Showell, Marian G
Jordan, Vanessa
Hart, Roger J
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2020-08-27
Volume: 2026
Issue: 3
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd007807.pub4
OpenAlex: W4211059826
Cited by: 119
References: 171
Citations by year: 2026: 7 · 2025: 21 · 2024: 26 · 2023: 30 · 2022: 19 · 2021: 13 · 2020: 3
FWCI: 2.39
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion)
ResearchSpace (University of Auckland) (submittedVersion)
Funders: Science and Technology Commission of Shanghai Municipality
Shahid Beheshti University of Medical Sciences
Arak University of Medical Sciences
Topics: Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Keywords: antioxidants, female subfertility, oxidative stress, live birth, clinical pregnancy, N-acetylcysteine, melatonin, L-arginine, myo-inositol, L-carnitine, selenium, vitamin E, vitamin C, vitamin D, coenzyme Q10, omega-3 fatty acids, B vitamins, infertility treatment

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