Apilot casecontrol studyoftheuse ofmelatoninin patients with multiple failed IVF cycles.

OBJECTIVE: Egg quality and therefore embryo quality is a limiting factor in IVF. Mitochondria supply ATP to cells, and higher levels are associated with better quality eggs. Excessive reactive oxygen species (ROS) are implicated in mitochondrial damage. Melatonin regulates reproductive physiology via gonadotropin release, but is also a powerful free radical scavenger and antioxidant. Our study examined the use of melatonin in IVF patients with multiple unsuccessful cycles. DESIGN: Retrospective case control study. MATERIALS AND METHODS: !?A3B2 tlsb=0.06pt?>From June 2012- April 2013, 13 women from Monash IVF Australia who had undergone at least two unsuccessful IVF cycles were given 4mg melatonin daily from the first day of follicle stimulating hormone. Two controls per case were matched for age, cycle number, stimulation type and dose; with consideration for BMI, infertility aetiology and andrology. Primary outcomes were oocyte quantity, oocyte maturity and utilization rates. Secondary outcomes included duration of FSH, peak oestrodial levels, number of follicles >11mm and clinical and biochemical pregnancies. T-tests were used to analyse continuous data and Fisher's exact test for categorical data; p<0.05 considered significant. RESULT(S): When the melatonin cases were compared to the matched controls, there were no statistically significant differences in any of the primary or secondary outcomes assessed. Interestingly, when melatonin cases were compared with their own previous cycle, oocyte number showed a trend towards increased value (5.1 vs 7.1, p=0.1744). Of clinical relevance, increase in mature oocyte numbers compared to previous cycles approached statistical significance (3.4 vs 4.9, p=0.0515). Duration of FSH, max E2, follicle number and utilization rate showed no significant changes. CONCLUSION(S): In patients with multiple unsuccessful IVF cycles, melatonin may improve oocyte quantity and increase development to mature oocytes. The trends in this small