Randomized controlled trial of astaxanthin impacts on antioxidant status and assisted reproductive technology outcomes in women with polycystic ovarian syndrome

• Published in: Journal of assisted reproduction and genetics Vol. 39; no. 4; pp. 995 - 1008
• Main Authors: Gharaei, Roghaye, Alyasin, Ashraf, Mahdavinezhad, Forough, Samadian, Esmaeil, Ashrafnezhad, Zhaleh, Amidi, Fardin
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.04.2022; Springer Nature B.V
• Subjects: Antioxidants; Antioxidants - pharmacology; Antioxidants - therapeutic use; Assisted Reproduction Technologies; Astaxanthin; Biomarkers; Cellular stress response; Clinical trials; Endocrine disorders; Female; Follicular fluid; Granulosa cells; Gynecology; Human Genetics; Humans; Medicine; Medicine & Public Health; NF-E2-Related Factor 2 - pharmacology; NF-E2-Related Factor 2 - therapeutic use; Oxidative Stress; Patients; Placebos; Polycystic ovary syndrome; Polycystic Ovary Syndrome - drug therapy; Polycystic Ovary Syndrome - genetics; Pregnancy; Reproductive Medicine; Reproductive Techniques, Assisted; Reproductive technologies; Supplements; Xanthophylls - pharmacology; Xanthophylls - therapeutic use; Antioxidant status; PCOS; Nrf2/ARE; Granulosa cell; Astaxanthin
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-022-02432-0

Purpose Polycystic ovary syndrome (PCOS), the most common endocrinopathy in women, is typically accompanied by a defective oxidative defense system. Here, we investigated the effect of astaxanthin (AST) as a powerful antioxidant on the oxidative stress (OS) response and assisted reproductive technology (ART) outcomes in PCOS patients. Methods In this double-blind, randomized, placebo-controlled trial, PCOS patients were randomly assigned into two groups. The intervention group received 8 mg AST, and the control group received the placebo daily for 40 days. The primary outcomes were the serum and follicular fluid (FF) levels of the OS biomarkers and the expression levels of the specific genes and proteins in the oxidative stress response pathway. The secondary outcomes were considered ART outcomes. Results According to our findings, a 40-day course of AST supplementation led to significantly higher levels of serum CAT and TAC in the AST group compared to the placebo group. However, there were no significant intergroup differences in the serum MDA and SOD levels, as well as the FF levels of OS markers. The expression of Nrf2, HO-1, and NQ-1 was significantly increased in the granulosa cells (GCs) of the AST group. Moreover, the MII oocyte and high-quality embryo rate were significantly increased in the AST group compared to the placebo group. We found no significant intergroup difference in the chemical and clinical pregnancy rates. Conclusion AST treatment has been shown to increase both serum TAC levels and activation of the Nrf2 axis in PCOS patients’ GCs. Trial Registration ClincialTrials.gov Identifier: NCT03991286.