Melatonin Helps IVF Success and Egg Quality

Melatonin may be able to help women with poor egg quality - typical of women in their mid thirties to early forties - who have low ovarian reserve to have more success with IVF. A new study has shown that women who take 3 mg of melatonin at night can expect to almost double the IVF success rates of women who don't take the supplement which is usually used for insomnia and jet-lag.

Melatonin may be protective when trying to conceive naturally also as the positive effects are achieved through protecting egg quality from free radical damage which is important however conception is achieved.

Melatonin is both a natural hormone, powerful antioxidant and free radical quencher produced in the pineal gland. Secretion is especially concentrated at night as the hormone has a role in inducing sleep cycles and production is stimulated by darkness. Melatonin levels are known to diminish with age and with exposure to light during sleep. Shift work is also very disturbing to melatonin secretion. Regular sleep in a totally dark room can help to keep your melatonin levels strong.

Previous studies on melatonin have show that it has a powerful regenerative action on the self-repair mechanisms within cells. This kind of protective activity can help to keep cell-division healthy, preventing damage to cellular DNA. This aspect of melatonin has been a focus of cancer research as healthy cell division is critical for keeping cells cancer free - it would seem that the same mechanisms can protect cell division in oocytes (eggs) too.

Excessive oxidative stress caused by free radicals within ovarian follicles is thought to be an important cause of poor egg quality. Oxidative damage can cause substantial harm, damaging DNA and negatively altering chromosomes and the way that cells divide. These forms of damage can make an egg infertile and increase the risks of birth defects.

Antioxidants such as melatonin naturally fight free radicals and minimize the damage that they cause. Melatonin seems to be more effective and protective than most other antioxidants in this capacity as it has multiple protective effects and stimulates the activity of other antioxidants too.

Some oxidative stress and inflammation is essential for ovulation to occur in natural conception cycles. As the egg bursts out of the follicle - which is a process driven by inflammation - antioxidants such as melatonin confer critical protection against some of the damage that naturally occurs at this time. Previous studies have shown that melatonin within ovarian follicles does powerfully protect eggs from the kind of oxidative stress that happens during ovulation.

The new research on melatonin and IVF was pioneered by Dr. Hiroshi Tamura, a Japanese researcher from Yamaguchi University, Japan. This study measured the levels of an oxidizing free radical molecule (8-OHdG) contained within the follicular fluid and known to have a damaging effect on oocytes (eggs) within the follicles. The researchers discovered that as melatonin levels increase within follicular fluid - the levels of the harmful oxidizing molecules decreased. Bravo.

Other studies have shown that melatonin powerfully scavenges various kinds of free radicals that cause oxidative damage - in oocytes and sperm - and does so more effectively than many other kinds of antioxidants - especially when protecting DNA.

When the researchers tested the theory that melatonin may be have a protective role in IVF they selected a large group of women who had already failed an IVF cycle due to poor egg quality. Approximately half were given 3 mg of melatonin at 10pm at night and the other half were not given any. This quantity of melatonin was found to both boost the levels of melatonin within ovarian follicles and drop the levels of the damaging pro-oxidant 8-OhdG.

When the oocytes (eggs) for the IVF were fertilized, the oocytes from the melatonin group had a 50% fertilization rate and a 19% pregnancy rate.

In the group without melatonin the fertilization rate was almost halved at 22.8% as was the pregnancy rate at 10.2%.

The study concluded that:
"oxidative stress causes toxic effect on oocyte maturation and melatonin protects oocytes from oxidative stress. Melatonin administration is likely to improve oocyte quality."

Other studies have shown that women with higher levels of antioxidants in follicular fluid have higher fertilization rates too but this is the first time melatonin has been measured in this capacity. This mechanism may be another reason why the Mediterranean diet improves fertility also - it is rich in naturally occurring antioxidants.

The lead researcher in the IVF study, Dr. Tamura, stated that "Despite great advances in assisted reproductive technology, poor oocyte quality remains a serious problem for female infertility, and so far no practical and effective treatment for improving oocyte quality has been established. Our work show that oxidizing agents can lessen oocyte quality, and that this can be countered by action of the hormone melatonin. In addition, our clinical trial shows that melatonin treatment improves oocyte quality, leading to a higher fertilization rate."

The study "Melatonin and Reproduction Revisited" describes melatonin as "...an uncommonly safe molecule that lacks demonstrable toxicity even when given in exceptionally high doses throughout pregnancy..." which is reassuring. It is important not to take melatonin before driving or operating machinery, it can make you very sleepy.

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International Federation of Fertility Societies
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