What Are Anti-oxidants?
Anti-oxidants are substances that reduce oxidative stress, which is the leading cause of DNA fragmentation (damage to genetic material) in eggs and sperm. The greater the level of DNA fragmentation, the worse the outcome of IVF treatment.
Examples of anti-oxidants include melatonin and coenzyme Q10 (CoQ10).
Melatonin is a very powerful anti-oxidant. It has been suggested that its anti-oxidative actions in follicular fluid may reduce the death of important cells and allow growing follicles to fully develop and provide mature (fertilisable) eggs for ovulation or egg collection.
The production of CoQ10 by your body slows as you age, and it is postulated that makes your body less effective at guarding your eggs from oxidative damage. It has been suggested that taking CoQ10 prevents, or even reverses,age-related egg quality and quantity deterioration.
Sperm are also sensitive to oxidative stress, and as a consequence sperm count and qualiy may also be reduced, and fertility compromised. The potential protective effect of anti-oxidants, such as CoQ10, has been raised as a possible way of improving sperm quality and quantity.
Is This Treatment Necessary?
In women undergoing IVF treatment, a recent meta-analysis (detailed examination) of Randomised Controlled Studies (RCTs), the highest quality type of studies, found no evidence for an increased Live Birth Rate (LBR) with the use of anti-oxidants compared to placebo (dummy medication) or no treatment. There was not even a statistically significant in the Clinical Pregnancy Rate (CPR),which is the presence of fetal heart beat on an early ultrasound examination.
In men taking part in IVF treatment, there are two RCTs comparing anti-oxidants with placebo. Whilst a meta-analysis of these two studies showed a higher LBR when anti-oxidant was taken , the result should be viewed cautiously for statistical reasons including the small numbers recruited to the trials.
What Are The Risks?
There are no significant risks associated with taking anti-oxidants in the recommended dosage.
Are There Other Options?
Both moderate exercise and weight reduction have been shown to improve sperm test results, probably because obesity is a high oxidative stress.
The same applies to women, obesity being associated with an increased likelihood of failure to achieve a live birth with IVF treatment.
What Happens If I do Not Take Anti-oxidants?
On currently available good quality evidence, if you do not take anti-oxidants, the outcome of your IVF treatment should not be affected.
Will Taking Anti-oxidants Increase My Chances Of Having A Healthy Normal Baby?
The quality and size of studies performed so far does not justify the routine use of anti-oxidants in IVF treatment, but the absence of side effects and relatively low cost may be tempting.
Ideally, participation in large well-designed RCTs would provide a definitive answer.