Effect of melatonin addition in ovulation induction protocols with clomiphene citrate in management of infertility

Authors

  • Anjali Chaudhary Department of Obstetrics and Gynecology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
  • Aditi Agarwal Department of Obstetrics and Gynecology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
  • Meenakshi Tanwar Department of Obstetrics and Gynecology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
  • Parul Singh Department of Obstetrics and Gynecology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India
  • Priyanka Negi Department of Obstetrics and Gynecology, Sri Guru Ram Rai Institute of Medical and Health Science, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20214638

Keywords:

Infertility, Antioxidants, Melatonin, Ovulation induction, Clomiphene citrate

Abstract

Background: About 10-12% of couples are unable to conceive by natural means despite concerted efforts and these figures have risen in past few decades. In recent years, effect of oxidative stress on the fertility has been widely recognised. Oxidative stress has been known to affect both male and female fertility reducing sperm count and motility in men, and affecting ovum reserve and quality in women. Melatonin is the secretion of the pineal gland responsible for circadian sleep rhythm has also shown to be good antioxidant. Aim and objective of current study was to study effect of melatonin addition to clomiphene citrate for induction of ovulation with a view to improve conception rates.

Methods: This was a retrospective analysis of 52 women with infertility who were given clomiphene citrate with melatonin. Ovulation, conception rates and pregnancy outcomes were noted.

Results: We observed 77.8%ovulation rates, and a significantly better conception and live birth rates.

Conclusions: Melatonin, as an anti-oxidant may improve, conception and live birth rates when added to clomiphene citrate induction protocols.

References

Shavi F, Luk R. Melatonin: shedding light on infertility? - a review of the recent literature. J Ovarian Res. 2014;7:98.

Walczak-Jedrzejowska R, Wolski JK, Slowikowska-Hilczer J. The role of oxidative stress and antioxidants in male fertility. Cent European J Urol. 2013;66(1): 60-7.

Sindhia V, Guptaa V, Sharma S, Kumaria BR, Neeti D. Potential applications of antioxidants - A review. J Pharm Res. 2013;7(9):828-83.

Tamura H, Takasaki A, Taketani T, Tanabe M, Kizuka F, Lee L, et al. The role of melatonin as an antioxidant in the follicle. J Ovarian Res. 2012;5:5.

Partonen T. Melatonin-dependent infertility. Med Hypotheses. 1999;52(5):487-8.

Brzezinski A, Seibel MM, Lynch HJ, Deng MH, Wurtman RJ. Melatonin in human preovulatory follicular fluid. J Clin Endocrinol Metab. 1987; 64(4):865-7.

Poeggeler B, Reiter RJ, Tan DX, Chen LD, Manchester LC. Melatonin, hydroxyl radical-mediated oxidative damage, and aging: a hypothesis. J Pineal Res. 1993;14(4):151-68.

Rahman K. Studies on free radicals, antioxidants, and co-factors. Clin Interv Aging. 2007;2:219-36

Fernando S, Osianlis T, Vollenhoven B. A pilot double-blind randomised placebo-controlled dose–response trial assessing the effects of melatonin on infertility treatment (MIART): study protocol. BMJ. 2014;4:e005986.

Zeng H, Ren Z, Yeung W. Low mitochondrial DNA and ATP contents contribute to the absence of birefringent spindle imaged with PolScope in in vitro matured human oocytes. Hum Reprod. 2007; 22:1681-6.

Song C, Peng W, Yin S, Zhao J, Fu B, Zhang J, et al. Melatonin improves age-induced fertility decline and attenuates ovarian mitochondrial oxidative stress in mice. Sci Rep. 2016 Oct 12;6:35165.

Usadi R, Fritz M. Induction of ovulation with clomiphene citrate. Glob Libr Women's Med. 2008;23:512-9.

Seyedoshohadaei F, Zandvakily F, Shahgeibi S. Comparison of the effectiveness of clomiphene citrate, tamoxifen and letrozole in ovulation induction in infertility due to isolated unovulation. Iran J Reprod Med. 2012;10(6):531-6.

Salvatore Giovanni Vitale, Paola Rossetti, Francesco Corrado, Agnese Maria Chiara Rapisarda, Sandro La Vignera, Rosita Angela Condorelli, Gaetano Valenti, Fabrizio Sapia, Antonio Simone Laganà, and Massimo Buscema How to Achieve High-Quality Oocytes? The Key Role of Myo-Inositol and Melatonin. Int J Endocrinol. 2016; 2016: 4987436

Vittorio U, Vitale SG, Rossetti P, Corrado F. How to Achieve High-Quality Oocytes? The Key Role of Myo-Inositol and Melatonin. Int J Endocrinol. 2016;2016:4987436.

Leridon H. Can assisted reproduction technology compensate for the natural decline in fertility with age? A model assessment. Hum Reprod. 2004; 19(7):1548-53.

Wiener-Megnazi Z, Vardi L, Lissak A, Shnizer S, Reznick AZ, Ishai D, et al. Oxidative stress indices in follicular fluid as measured by the thermochemiluminescence assay correlate with outcome parameters in in vitro fertilization. Fertil Steril. 2004;82(3):1171-6.

Berridge MJ. Inositol lipids and cell proliferation. Biochim Biophys Acta. 1987;907(1):33-45.

Hu KL, Ye X, Wang S, Zhang D. Melatonin Application in Assisted Reproductive Technology: A systematic review and meta-analysis of randomized trials. 2020;11:333.

Ludmila MD, Seko, Raphael M, Moroni V, et al. Melatonin supplementation during controlled ovarian stimulation for women undergoing assisted fertility technology: A systematic and review and Meta-analysis of randomised controlled trials. Fertil Steril. 2014;101(1):282-84.

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Published

2021-11-25

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Original Research Articles