Utility of antioxidants during assisted reproductive techniques : an evidence based review
Date
2014-11-24
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Assisted reproductive technology (ART) is a common treatment of choice for many couples facing infertility issues,
be it due to male or female factor, or idiopathic. Employment of ART techniques, however, come with its own
challenges as the in vitro environment is not nearly as ideal as the in vivo environment, where reactive oxygen
species (ROS) build-up leading to oxidative stress is kept in check by the endogenous antioxidants system. While
physiological amounts of ROS are necessary for normal reproductive function in vivo, in vitro manipulation of
gametes and embryos exposes these cells to excessive ROS production either by endogenous or exogenous
environmental factors. In this review, we discuss the sources of ROS in an in vitro clinical setting and the influence
of oxidative stress on gamete/embryo quality and the outcome of IVF/ICSI. Sources of ROS and different strategies
of overcoming the excessive generation of ROS in vitro are also highlighted. Endogenously, the gametes and the
developing embryo become sources of ROS. Multiple exogenous factors act as potential sources of ROS, including
exposure to visible light, composition of culture media, pH and temperature, oxygen concentration, centrifugation
during spermatozoa preparation, ART technique involving handling of gamete/embryo and cryopreservation
technique (freeze/thawing process). Finally, the use of antioxidants as agents to minimize ROS generation in the
in vitro environment and as oral therapy is highlighted. Both enzymatic and non-enzymatic antioxidants are
discussed and the outcome of studies using these antioxidants as oral therapy in the male or female or its use
in vitro in media is presented. While results of studies using certain antioxidant agents are promising, the current
body of evidence as a whole suggests the need for further well-designed and larger scale randomized controlled
studies, as well as research to minimize oxidative stress conditions in the clinical ART setting.
Description
CITATION: Agarwal, A., Durairajanayagam, D. & Du Plessis, S. S. 2014. Utility of antioxidants during assisted reproductive techniques: an evidence based review. Reproductive Biology and Endocrinology, 12:112, doi:10.1186/1477-7827-12-112.
The original publication is available at http://rbej.biomedcentral.com
The original publication is available at http://rbej.biomedcentral.com
Keywords
Reactive oxygen species, Oxidative stress, Antioxidants, Assisted reproductive technology, In vitro fertilization, Intracytoplasmic sperm injection, Reproductive technology, Active oxigen, Embryos
Citation
Agarwal, A., Durairajanayagam, D. & Du Plessis, S. S. 2014. Utility of antioxidants during assisted reproductive techniques: an evidence based review. Reproductive Biology and Endocrinology, 12:112, doi:10.1186/1477-7827-12-112.