Melatonin supplementation and outcomes after assisted reproductive technology: A systematic review and meta-analyses

Abstract To assess the effect of melatonin (MT) supplementation on the outcomes of ART. A meta-analysis and systematic review was conducted. Eleven studies were included in this meta-analysis. Clinical pregnancy rate (CPR), live birth rate (LBR), Miscarriage rate (MR), fertilization rate (FR), Number of oocyte, MII oocyte, top-quality embryo were reported in 10, 3, 6, 7, 9, 8, and 6 studies, respectively. MT supplementation significantly increased the CPR, the No. of MII oocyte, the No. of top-quality embryo, and the FR. However, there was no significant difference in LBR, No. of oocyte, and the MR. When studies were sub-grouped by the interventions, no matter the control group is MI+FA or placebo/none, MT supplementation increased No. of MII oocyte and No. of top embryo, whereas showed similar CPR. When studies were sub-grouped according to women’s characteristic, MT supplementation showed no significant benefit on CPR in women with PCOS, with normal ovary function, and with previous low fertilization or poor-quality embryo. However, MT supplementation increased the No of MII in women with PCOS, but did not show benefit in women with normal ovary function. MT supplementation may not improve the CPR and LBR of ART. But MT seems be beneficial to the quality of oocyte and embryo, especially for women with PCOS and DOR. Further well-designed studies are needed before the recommendation of its clinical use.