The effects of oral antioxidants on outcomes of assisted reproductive technology: a systematic review and meta-analysis of randomized controlled trials
Abstract
Background: The clinical efficacy of antioxidants in assisted reproductive technology (ART) remains inconsistent. This systematic review and meta-analysis aimed to evaluate the impact of oral antioxidant supplementation on reproductive outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET).
Methods: We systematically searched PubMed, Scopus, Embase, and Web of Science databases from inception to February 2026 for randomized controlled trials (RCTs) investigating oral antioxidants in patients undergoing ART. We performed meta-analyses by pooling effect sizes, conducting subgroup analyses, and exploring heterogeneity. Methodological quality was assessed using the Risk of Bias (RoB) tool, and the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Sensitivity analyses and publication bias assessments were also conducted.
Results: This meta-analysis suggests that oral antioxidant supplementation may provide potential clinical benefits for women undergoing IVF/ICSI-ET. The pooled estimates indicated a significant improvement in the clinical pregnancy rate (RR = 1.29, 95% CI: 1.070-1.554), the number of morphologically mature oocytes (MII oocytes) (MD = 2.99, 95% CI: 1.82-4.16), the number of high-quality embryos (MD = 1.08, 95%CI: 0.69-1.47), and the live birth rate (RR = 1.407, 95% CI: 1.052-1.881). Due to the limited number of included…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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