Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 15 , ISSUE 2 ( March-April, 2023 ) > List of Articles


Role of Antioxidants in the Treatment of Unexplained Infertility

Tusharika Rai, Fareha Khatoon, Suman Nishad, Amrita Singh, Bandana Sharma, Shriya Gulati

Keywords : Antioxidants, Oxidative stress, Unexplained infertility

Citation Information : Rai T, Khatoon F, Nishad S, Singh A, Sharma B, Gulati S. Role of Antioxidants in the Treatment of Unexplained Infertility. J South Asian Feder Obs Gynae 2023; 15 (2):203-208.

DOI: 10.5005/jp-journals-10006-2096

License: CC BY-NC 4.0

Published Online: 11-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To evaluate the role of free radical induced oxidative stress in the etiopathogenesis of unexplained infertility by biochemical estimation of oxidants and antioxidants levels. Objectives: • To evaluate the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione reductase before antioxidant supplementation. • To compare the effect of antioxidants (vitamin C 790 mg/day, vitamin E 15 mg/day, zinc 10 mg/day, Se 55 μg/day) given for 6 months on fertility outcome in patients with unexplained infertility by evaluating the levels of MDA, SOD, and glutathione reductase post supplementation. Materials and method: This prospective study is carried out on 100 patients in LLR and associated hospital, Department of Obstetrics and Gynaecology, Kanpur, during the period from January 2014 to October 2015. Specific investigation of lipid peroxidation product MDA, SOD, and glutathione reductase (GR) was done initially at the 1st visit (baseline level) and then after supplementation of antioxidants for 6 months. Patients with other causes of infertility were excluded. Results: Out of 100 patients, 30 were controls with spontaneous conception, and 70 were patients with unexplained infertility. Out of these 70 patients, 36 were given antioxidants from outside. Levels of MDA were significantly higher, and levels of GR and SOD were significantly lower in patients with unexplained infertility when compared with patients with spontaneous conception. There was an improvement in pregnancy outcome by supplementation with antioxidants from outside. Conclusion: An imbalance in the level of oxidants and antioxidants leading to oxidative stress can affect the quality of gametes and can be the cause of unexplained infertility. Antioxidant supplementation from outside can improve fertility outcomes in these patients.

  1. Mehta AV, Modi AP, Raval BM, et al. Role of diagnostic hysterolaparoscopy in the evaluation of infertility. Int J Reprod, Contracept, Obstet Gynecol 2016;5(2):437–440. DOI: 10.18203/2320-1770.ijrcog20160385.
  2. Fujii J, Iuchi Y, Okada F. Fundamental roles of reactive oxygen species and protective mechanisms in the female reproductive system. Reprod Biol Endocrinol 2005;3:43. DOI: 10.1186/1477-7827-3-43.
  3. Pizzino G, Irrera N, Cucinotta M, et al. Oxidative stress: harms and benefits for human health. Oxid Med Cell Longev 2017;2017:1–13. PMCID: PMC5551541.
  4. Ighodaro O, Akinloye O. First line defence antioxidants-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPX): their fundamental role in the entire antioxidant defence grid. Alexandria J Med 2018;54(4):287–293. DOI: 10.1016/j.ajme.2017.09.001.
  5. Agarwal A, Gupta S, Sharma R. Oxidative stress and its implications in female infertility – a clinician's perspective. Reprod Biomed Online 2005;11(5):641–650. DOI: 10.1016/s1472-6483(10)61174-1.
  6. Ohkawa H, Ohishi N, Yagi K. Assay for lipid peroxides in animal tissues by thiobarbituric acid reaction. Anal Biochem 1979;95(2):351–358. DOI: 10.1016/0003-2697(79)90738-3.
  7. McCord JM, Fridovich I. Superoxide dismutase. An enzymic function for erythrocuprein (hemocuprein). J Biol Chem 1909;244(22):6049–6065. PMID: 5389100.
  8. Youssef MAFM, Abdelmoty HI, Elashmwi HA, et al. Oral antioxidants supplementation for women with unexplained infertility undergoing ICSI/IVF: randomized controlled trial. HumFertil (Camb) 2015;18(1):38–42. DOI: 10.3109/14647273.2014.927595.
  9. Agarwal A, Allamaneni SSR. Role of free radicals in female reproductive disease and assisted reproduction. Reprod Biomed Online 2004;9(3):338–347. DOI: 10.1016/s1472-6483(10)62151-7.
  10. Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2005;3:28. DOI: 10.1186/1477-7827-3-28.
  11. Veena BS, Upadhya S, Adiga SK, et al. Evaluation of oxidative stress, antioxidants and prolactin in infertile women. Indian J Clin Biochem 2008;23(2):186–190. DOI: 10.1007/s12291-008-0041-3.
  12. Murphy AA, Palinski W, Rankin S, et al. Macrophage scavenger receptor(s) and oxidatively modified proteins in endometriosis. Fertil Steril 1998;69(6):1085–1091. DOI: 10.1016/s0015-0282(98)00088-0.
  13. Hosseini B, Eslamian G. Association of micronutrient intakes with female infertility: review of recent evidence. Thrita 2015;4(1). DOI: 10.5812/thrita.25586.
  14. Pyari J. Free radicals in female infertility. J Obstet Gynecol India 2006;56(1):64–67.
  15. Wang Y, Sharma RK, Falcone T, et al. Importance of reactive oxygen species in the peritoneal fluid of women with endometriosis or idiopathic infertility. Fertil Steril 1997; 68(5):826–830. DOI: 10.1016/s0015-0282(97)00343-9.
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