Clinical efficacy of in vitro fertilization in patients treated with melatonin during preconception care


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Abstract

Objective: To investigate the clinical efficacy of preconception care with exogenous melatonin for in vitro fertilization (IVF). Materials and methods: This nonrandomized controlled trial included 84 infertile women undergoing IVF and ex/eriencing slee/ disorders and elevated stress reactions. Patients in grou/ 1 (n=39) received/reconce/tion care with melatonin; women in grou/ 2 (n=45) did not receive melatonin. The effectiveness of melatonin was assessed based on the results of ovarian stimulation, com/arative evaluation of melatonin concentrations in the follicular fluid, monitoring of the culture stage, determination of the genetic status of embryos, and /regnancy rate. Results: Use of melatonin in /atients undergoing IVF /rograms was associated with a significantly higher number of oocyte-cumulus com/lexes and a higher fertilization rate. There were no statistically significant differences in melatonin levels in the follicular fluid in /atients who received and did not receive melatonin. There was an association between marginal values of melatonin levels (less than 10%o and more than 90%o) and the frequency of obtaining embryos of low mor/hological quality [risk difference, %=61.9 (15.91-74.99), /(x2)<0.009]. Melatonin administration increased the /robability of obtaining blastocysts of high mor/hological quality by 41.7% [risk difference 41.7%, /<0.001], reduced the /robability (RR=0.29 (0.09- 0.97)) of obtaining only low quality blastocysts by 3.37 times (1/0.29), reduced the risk (RR=0.52 (0.29-0.92)) of obtaining aneu/loid blastocysts by almost 2 times (1/0.52) and increased the /robability of /regnancy in the cryonreservation cycle by 2.5 times [OR=2.44 (1.17-5.11)]. Conclusion: The study findings suggest a /ositive role for exogenous melatonin administration on the clinical and biological outcomes of IVF. More studies investigating the effect of melatonin on re/roductive function are needed to form a conce/t of/reconce/tion care with melatonin su//lementation.

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About the authors

Olesya S. Vakhlova

Ural State Medical University, Ministry of Health of Russia; Partus Center for Reproductive Disorders

Email: dr.vakhlova@mail.ru
Postgraduate Student, Obstetrician-Gynecologist at the Department of Obstetrics and Gynecology

Tatyana A. Oboskalova

Ural State Medical University, Ministry of Health of Russia

Email: oboskalova.tat@yandex.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Elena V. Kvashnina

Partus Center for Reproductive Disorders

Email: doctor.kvashnina@gmail.com
PhD, Chief Physician

Elena A. Mukhlynina

Institute of Immunology and Physiology, Ural Branch of Russian Academy of Sciences

Email: elena.mukhlynina@yandex.ru
PhD (Bio), Senior Researcher, Head of the Collective Use Center

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