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Melatonin improved the outcomes of women with ART: a systematic review and meta-analysis of randomized trials

Wu Y, Huang W, Tang L, Feng Y, Chen H, Pan M, Peng J, Li C et al.

Frontiers in reproductive health, 2025

1,481 participants · 5 citations

Abstract

Objective: To systematically evaluate whether the melatonin supplementation could improve the embryo development and pregnancy outcomes of infertile women undergoing assisted reproductive technologies (ART).

Methods: This systematic review and meta-analysis followed the PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251003042). The randomized controlled trials (RCTs) published before March 5, 2025 are included to evaluate the efficacy of melatonin on infertile women undergoing ART. Eligible studies reported at least one embryo development or pregnancy-related outcome. Primary outcome was clinical pregnancy rate; secondary outcomes including oocyte yield, fertilization rate, MII oocyte number, and high-quality embryo formation. Subgroup analyses were conducted based on stimulation protocols, melatonin dosage, and population characteristics. Risk of bias was assessed using the Cochrane Risk of Bias tool, and pooled effect sizes were calculated using fixed- or random-effects models depending on heterogeneity. Totally, eleven RCTs with a total of 1,481 participants were analyzed here.

Data sources: PubMed/MEDLINE, Embase, and Cochrane Library.

Results: Melatonin supplementation significantly improved clinical pregnancy rate (OR = 1.59, 95% CI: 1.22-2.07). Regarding embryo development, melatonin significantly increased the number of high-quality embryos (MD = 0.43, 95% CI: 0.07-0.79), MII oocyte (SMD=0.99, 95% CI: 0.29-1.69), and fertilization rates (OR =…

How strong is the evidence?

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. Reported size: 1,481 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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