To the Editor
We read with interest a recent study in RBMO (
Ochiai et al., 2019
) reporting the detrimental effects of resveratrol supplementation on pregnancy outcomes in IVF-embryo transfer cycles. However, caution should be exercised concerning the robustness of these findings.Firstly, the two groups were of unequal sample size and not balanced with respect to almost all baseline characteristics. Notably, the supplementation group had considerably more fresh embryo transfer cycles than control. Since mild stimulation protocols with clomiphene citrate were applied to all women, the decrease in endometrial receptivity and implantation caused by clomiphene citrate in fresh embryo transfer could not be simply ruled out (
Palomino et al., 2005
). Although multiple regression analysis was performed, there remained a variety of important confounders for adjustment such as body mass index, endometrial thickness and infertility indications.Secondly, the authors suggested that resveratrol was mainly used in women with diminished ovarian reserve, as reflected by the average age of nearly 40 years. This application is rational for the purpose of improving ovarian function, but may be out of scope for embryo transfer. Resveratrol treatment has been demonstrated to reduce weight in obesity (
Tabrizi et al., 2018
), ameliorate hyperandrogenemia and insulin resistance in polycystic ovary syndrome (Banaszewska et al., 2016
), as well as suppress ectopic endometrial invasiveness and inflammation in endometriosis (Kolahdouz Mohammadi and Arablou, 2017
). Due to the negative influences of these diseases on pregnancy outcomes (Rittenberg et al., 2011
, Katulski et al., 2015
, Saraswat et al., 2017
), resveratrol may be of more benefit for certain populations in embryo transfer cycles.References
- Effects of resveratrol on polycystic ovary syndrome: a double-blind, randomized, placebo-controlled trial.J. Clin. Endocrinol. Metab. 2016; 101: 4322-4328
- Pregnancy complications in polycystic ovary syndrome patients.Gynecol. Endocrinol. 2015; 31: 87-91
- Resveratrol and endometriosis: In vitro and animal studies and underlying mechanisms (Review).Biomed. Pharmacother. 2017; 91: 220-228
- Influence of resveratrol supplementation on pregnancy outcomes inin vitro fertilization–embryo transfer cycles.Reprod. Biomed. Online. 2019; ([Epub ahead of print])
- Differential expression of endometrial integrins and progesterone receptor during the window of implantation in normo-ovulatory women treated with clomiphene citrate.Fertil. Steril. 2005; 83: 587-593
- Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis.Reprod. Biomed. Online. 2011; 23: 421-439
- Pregnancy outcomes in women with endometriosis: a national record linkage study.BJOG. 2017; 124: 444-452
- The effects of resveratrol intake on weight loss: a systematic review and meta-analysis of randomized controlled trials.Crit. Rev. Food. Sci. Nutr. 2018; : 1-16
Article info
Publication history
Published online: April 25, 2019
Accepted:
April 11,
2019
Received:
April 2,
2019
Footnotes
Declaration: The authors declare no financial or commercial conflict of interest.
Identification
Copyright
© 2019 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
