Astaxanthin ameliorates inflammation, oxidative stress, and reproductive outcomes in endometriosis patients undergoing assisted reproduction: A randomized, triple-blind placebo-controlled clinical trial

Abstract

PurposeIn a randomized, triple-blind, placebo-controlled clinical trial (RCT) including 50 infertile women with endometriosis candidate for assisted reproductive techniques (ART), we studied the effect of Astaxanthin (AST) on pro-inflammatory cytokines, oxidative stress (OS) markers, and early pregnancy outcomes.MethodsBefore and after 12 weeks of AST treatment (6 mg per day), blood serum and follicular fluid (FF) samples were collected from 50 infertile women with endometriosis stage III/IV undergoing ART. Pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and OS markers (malondialdehyde [MDA], superoxide dismutase [SOD], catalase [CAT], and total antioxidant capacity [TAC]) were measured in the serum and FF. ART outcomes were also compared between the groups.ResultsIncreased serum levels of TAC (398.661 ± 57.686 vs. 364.746 ± 51.569; P = 0.004) and SOD (13.458 ± 7.276 vs. 9.040 ± 5.155; P = 0.010) were observed after AST therapy in the treatment group. Furthermore, serum MDA (14.619 ± 2.505 vs. 15.939 ± 1.512; P = 0.031) decreased significantly following antioxidant treatment. In addition, significantly lower serum levels of IL-1β (4.515 ± 0.907 vs. 6.8760 ± 0.8478; P = 0.000), IL-6 (5.516 ± 0.646 vs. 5.0543 ± 0.709; P = 0.024) and TNF-α (2.520 ± 0.525 vs. 2.968 ± 0.548; P = 0.038) were observed after AST treatment. In addition, AST supplementation led to an improved number of oocytes retrieved (14.60 ± 7.79 vs. 9.84 ± 6.44; P = 0.043), number of mature (MII) oocytes (10.48 ± 6.665 vs. 6.72 ± 4.3; P = 0.041), and high-quality embryos (4.52 ± 2.41 vs. 2.72 ± 2.40; P = 0.024).ConclusionAST pretreatment can modulate inflammation and OS in endometriosis-induced infertile patients. ART outcomes also improved after 12 weeks of AST therapy. Our results suggest that AST can be a potential therapeutic target for infertile patients with endometriosis undergoing ART.

Spatiotemporal Trends and Age–Period–Cohort Analysis for the Burden of Endometriosis-Related Infertility: An Analysis of the Global Burden of Disease Study 2019

“…It has been reported that the use of synthetic progestins prior to in vitro fertilization and embryo transfer has no significant benefit on clinical outcomes in endometriosis-associated infertility [ 21 ]. A recent study suggests that astaxanthin, with its anti-inflammatory and antioxidant properties, may be a reliable intervention for the prevention of endometriosis-related infertility [ 22 ]. Endometriosis-associated infertility already causes physical and psychological distress and suffering for both patients and their partners [ 23 , 24 ], and understanding its long-term disease burden will help to increase the importance of preventing endometriosis from the beginning and managing endometriosis-associated infertility.…”

Melatonin Levels and Embryo Quality in IVF Patients with Diminished Ovarian Reserve: A Comparative Study

“…The follicular uid was collected concurrently with oocyte retrieval [23]. Brie y, transvaginal ultrasoundguided oocyte retrieval was conducted 36-37 hours following hCG injection, coinciding with the collection of follicular uid.…”

Generation of Porcine and Rainbow Trout 3D Intestinal Models and Their Use to Investigate Astaxanthin Effects In Vitro

“…Astaxanthin (AST) is a natural lipid-soluble and red–orange xanthophyll carotenoid widely found in marine seafood, such as shrimp, lobster, and crab, especially in their shell portions, and in several microorganisms, such as Phaffia rhodozyma and certain algae [ 1 , 2 , 3 ]. AST’s capacity to regulate inflammatory responses by preventing free radical formation and modulating redox balance has been described by a number of studies carried out in different species, mostly in vivo [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Thanks to these properties, AST finds applications in pharmaceutical, nutraceutical, and cosmetic industries, with various health benefits in humans [ 6 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”