Utility of antioxidants during assisted reproductive techniques: an evidence based review

Reproductive Biology and Endocrinology

Stefan S du Plessis¹  Damayanthi Durairajanayagam³  Ashok Agarwal² 

[1] Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg 7505, South Africa;Center for Reproductive Medicine, Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA;Discipline of Physiology, Faculty of Medicine, MARA University of Technology, Sungai Buloh, Selangor, 47000, Malaysia

关键词: ART outcome;    Intracytoplasmic sperm injection;    In vitro fertilization;    Assisted reproductive technology;    Antioxidants;    Oxidative stress;    Reactive oxygen species;   

Others  :  1139726
DOI  :  10.1186/1477-7827-12-112

 received in 2014-08-12, accepted in 2014-11-06,  发布年份 2014

【 摘 要 】

Assisted reproductive technology (ART) is a common treatment of choice for many couples facing infertility issues, be it due to male or female factor, or idiopathic. Employment of ART techniques, however, come with its own challenges as the in vitro environment is not nearly as ideal as the in vivo environment, where reactive oxygen species (ROS) build-up leading to oxidative stress is kept in check by the endogenous antioxidants system. While physiological amounts of ROS are necessary for normal reproductive function in vivo, in vitro manipulation of gametes and embryos exposes these cells to excessive ROS production either by endogenous or exogenous environmental factors. In this review, we discuss the sources of ROS in an in vitro clinical setting and the influence of oxidative stress on gamete/embryo quality and the outcome of IVF/ICSI. Sources of ROS and different strategies of overcoming the excessive generation of ROS in vitro are also highlighted. Endogenously, the gametes and the developing embryo become sources of ROS. Multiple exogenous factors act as potential sources of ROS, including exposure to visible light, composition of culture media, pH and temperature, oxygen concentration, centrifugation during spermatozoa preparation, ART technique involving handling of gamete/embryo and cryopreservation technique (freeze/thawing process). Finally, the use of antioxidants as agents to minimize ROS generation in the in vitro environment and as oral therapy is highlighted. Both enzymatic and non-enzymatic antioxidants are discussed and the outcome of studies using these antioxidants as oral therapy in the male or female or its use in vitro in media is presented. While results of studies using certain antioxidant agents are promising, the current body of evidence as a whole suggests the need for further well-designed and larger scale randomized controlled studies, as well as research to minimize oxidative stress conditions in the clinical ART setting.

【 授权许可】

   
2014 Agarwal et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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