title: Melatonin supplementation during controlled ovarian stimulation for women undergoing assisted reproductive technology: systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To examine the best evidence available regarding the effect of melatonin supplementation during controlled ovarian stimulation (COS) on the main assisted reproductive technology (ART) outcomes.
  
  
  METHODS
  Systematic review and meta-analysis of randomized clinical trials (RCT).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Women undergoing COS for ART.
  
  
  METHODS
  Melatonin supplementation during COS for women undergoing ART.
  
  
  METHODS
  Live birth rate, clinical pregnancy rate, number of retrieved oocytes, miscarriage rate, ovarian hyperstimulation syndrome (OHSS) rate, and number of congenital abnormalities. Comparisons were performed using risk ratio (RR) or mean difference (MD).
  
  
  RESULTS
  Five RCTs were considered eligible, and their data were extracted and included in a meta-analysis. No studies reported live-birth or congenital abnormalities. Our estimates were imprecise for distinguishing between no effect and benefit considering clinical pregnancy (RR, 1.21; 95% confidence interval [CI], 0.98-1.50, five studies, 680 women, low quality-evidence) and the number of oocytes retrieved (MD, 0.6; 95% CI, -0.2-2.2, five studies, 680 women, low quality-evidence). Our estimates were imprecise for distinguishing among harm, no effect, and benefit considering miscarriage (RR, 1.07; 95% CI, 0.43-2.68, two studies, 143 clinical pregnancies, low quality-evidence) and interventions to reduce the risk of OHSS (RR,1.01; 95% CI, 0.33-3.08, one study, 358 women, low quality-evidence).
  
  
  CONCLUSIONS
  More studies investigating the role of melatonin supplementation are still needed before recommending its use in clinical practice.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
authors.forename: Ludimila M D
authors.initials: LM
authors.lastname: Seko
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
authors.forename: Rafael M
authors.initials: RM
authors.lastname: Moroni
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
authors.forename: Valeria M S
authors.initials: VM
authors.lastname: Leitao
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Teixeira
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil; Ultrasonography and Retraining Medical School of Ribeirao Preto (EURP), Ribeirao Preto, Brazil.
authors.forename: Carolina O
authors.initials: CO
authors.lastname: Nastri
authors.affiliation: Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil; Ultrasonography and Retraining Medical School of Ribeirao Preto (EURP), Ribeirao Preto, Brazil. Electronic address: wpmartins@gmail.com.
authors.forename: Wellington P
authors.initials: WP
authors.lastname: Martins
mesh_terms: D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008550:Melatonin / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D027724:Reproductive Techniques, Assisted
chemical_list: D008550:Melatonin
keywords: Melatonin; assisted reproductive techniques; ovulation induction; review