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

Abstract

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.

Phytochemical composition and antioxidant activity of extracts of some medicinal plants in Tunisia

“…There is an increasing scientific interest in understanding effects of woody vegetation on agricultural lands for different aspects of human well-being, including the antioxidant activity (Žugić, et al, 2014) and nutrition (Agarwal, Durairajanayagam, & du Plessis, 2014). Provisioning ecosystem services from vegetation were reported in 74 of the reviewed articles.…”

Black Grape Seed Extract Modulates Fluoxetine-Induced Oxidative Stress and Cytotoxicity in the Mouse Testis

“…It is believed that OS development negatively impacts fertilization rates and pregnancy outcomes through the sperm membrane and DNA damage, and the prevention of OS is vital for the preservation of normal reproductive function (8). Furthermore, at the testis level, OS is involved in steroidogenesis impairment and germinal epithelium differentiation disruption (9,10).…”

Effects of granulocyte-macrophage colony-stimulating factor supplementation in culture medium on embryo quality and pregnancy outcome of women aged over 35 years

“…An important optimizing protocol is a supplementation of some embryokines to the culture medium [1][2][3][4][11][12][13][14][15]. Among various embryokines, granulocyte-macrophage colony-stimulating factor (GM-CSF) has attracted much attention.…”