• What Do Egg Quality and Sleep Have in Common? Melatonin.

      Poor egg quality is a difficult problem to treat for women of reproductive age who are trying to conceive. Many women who do have problematic egg quality only learn about this issue when they attempt IVF (in vitro fertilization). While IVF treatment can increase the quantity of eggs harvested, its impact on egg quality is negligible. Genetic analysis, including types of preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS) can test whether an embryo is chromosomally normal and/or free of certain genetic diseases. But what are the contributing factors to poor egg quality to begin with?

      Advanced age is the number one cause of poor egg quality - although young women of reproductive age can have poor egg quality as well as their older counterparts. Eggs don't just have an expiration date, however; there appear to be many more individual factors involved in egg quality. These individual variables to egg quality may or may not be related to a woman's age.

      A recent study presented at the 20th World Congress on Fertility and Sterility in Munich on September 15, 2010 has shed new light on at least one factor that adversely affects egg quality: oxidizing agents. Associate Professor Hiroshi Tamura from the Yamaguchi University Graduate School of Medicine in Japan and his colleagues examined a particular oxidizing agent in follicular fluid. Knowing that melatonin, a hormone that is commonly known as the sleep hormone, has anti-oxidizing qualities, the researchers put the two together - in mice.

      With encouraging results from murcine trials, the researchers began studying the relationship between melatonin and egg quality in women. Tamura's team split 115 women who were known "poor responders" into two groups: one group who received melatonin during their IVF cycle, and one group who did not. The results were significant: Twice as many eggs were successfully fertilized in the trial group (50%) than in the control group (22.8%). And almost twice as many women who had the melatonin-influenced eggs got pregnant as the women who did not take melatonin during their cycle.

      Ageing is hard on women's bodies and their eggs. But this study gives a few answers into why egg quality diminishes, and what factors can be changed to increase that quality. "Melatonin administration is likely to improve oocyte quality," according to Professor Tamura. Encouraging news for all women trying to conceive - especially poor responders.

      Study shows melatonin almost doubles IVF success rate in women with poor egg quality

      Press release - International Federation of Fertility Societies
      Wednesday 15 September 2010

      Poor egg (oocyte) quality is an important cause of female infertility. Low quality eggs may have several problems, for example they may not divide properly, or they may be missing certain chromosomes. Egg quality also declines with age, and certain medical conditions, such as PolyCystic Ovary Syndrome, can lead to poor quality eggs.

      New research presented at the World Congress of Fertility and Sterility in Munich has found that treating women with the hormone melatonin may help improve the egg quality in IVF.

      A group led by Associate Professor Hiroshi Tamura (Yamaguchi University Graduate School of Medicine, Japan) measured the presence of the oxidizing agent 8-OHdG in follicular fluids. High levels of oxidising agents such as 8-OHdG is an indicator of poor egg quality. The group found that as melatonin concentration in the folliclar fluids naturally increased, the level of 8-OHdG went down, leading the group to believe that melatonin was linked to the reduction of the stressing oxidising agents. Melatonin has known anti- oxidizing effects.

      They confirmed this finding in mice, and noted that addition of melatonin seemed to reduce the damage to the egg caused by the presence of oxidising agents.

      The group then initiated a trial with a group of women coming for IVF treatment at the Yamaguchi University Graduate School of Medicine. Women who had failed to become pregnant because of poor oocytes quality after one cycle of IVF were split into two groups; 56 women were given 3 mg of melatonin before the next IVF cycle, and 59 just received a standard IVF cycle without any melatonin.

      The team found that melatonin treatment significantly increased intrafollicular melatonin concentrations, and significantly decreased the concentration of the damaging 8-OhdG.

      The results of the study found that 50% of the eggs from women who taken melatonin could be successfully fertilised, as opposed to 22.8% in the control group. When the eggs were then transplanted into the womb, 19% (11 out of the total 56) of the women became pregnant, as opposed to 10.2% (6 out of total 59) in the control group.

      Associate Professor Tamura commented:
      “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. To our knowledge, our study represents the first clinical application of melatonin treatment for infertility patients. This work needs to be confirmed, but we believe that melatonin treatment is likely to become a significant option for improving oocyte quality in women who cannot become pregnant because of poor oocyte quality. Our next step is to analyze exactly how reactive oxygen species harm the oocyte, and how melatonin reduces oxidative stress in the oocyte”.


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