Resveratrol During IVF: Safety Concerns and Recommendations
Resveratrol supplementation should be avoided during In Vitro Fertilization (IVF) cycles, particularly during the luteal phase and embryo transfer, as it may decrease clinical pregnancy rates and increase miscarriage risk.
Evidence on Resveratrol and IVF
Potential Risks
- According to the Mayo Clinic Proceedings' 2021 perioperative guidelines, resveratrol should be held for 2 weeks before surgical procedures due to its antiplatelet effects via inhibition of COX pathways or cellular calcium channels 1.
- A 2019 clinical study found that resveratrol supplementation during embryo transfer cycles was associated with:
- Decreased clinical pregnancy rates (OR 0.539,95% CI 0.341-0.853)
- Increased risk of miscarriage (OR 2.602,95% CI 1.070-6.325) 2
- Resveratrol has been shown to have anti-deciduogenic actions in the uterine endometrium, which could interfere with embryo implantation and placentation 3.
Potential Benefits
- Some evidence suggests resveratrol may improve ovarian sensitivity to FSH in women of advanced reproductive age, potentially decreasing the risk of hypo-response to ovarian stimulation 4.
- Resveratrol upregulates SIRT1 expression in ovaries, which may protect against oxidative stress and improve ovarian function 3.
Clinical Recommendations for IVF Patients
Before Ovarian Stimulation
- If considering resveratrol supplementation, it should only be used during the pre-stimulation phase, at least 2 weeks before beginning IVF medications.
- A recent exploratory randomized controlled trial used 150 mg daily for three months preceding ovarian stimulation, which showed improved follicle output rate but no significant differences in pregnancy outcomes 4.
During Stimulation and After Embryo Transfer
- Resveratrol should be discontinued at least 2 weeks before embryo transfer.
- Absolutely avoid resveratrol during:
- The luteal phase
- After embryo transfer
- During early pregnancy
Special Considerations
- For women with diminished ovarian reserve or advanced maternal age, the potential benefits of improved ovarian response must be weighed against the risks to implantation.
- The teratogenic potential of resveratrol has not been fully ruled out, adding another reason to avoid its use during pregnancy 3.
Alternative Approaches
- The American Urological Association and American Society for Reproductive Medicine (2021) emphasize that supplements, including antioxidants and vitamins, have questionable clinical utility in treating infertility 5.
- Focus on established factors known to improve IVF outcomes:
- Maintaining a healthy weight
- Avoiding smoking and excessive alcohol
- Limiting exposure to environmental toxins
Conclusion
While resveratrol shows some promise for improving ovarian function in the pre-stimulation phase, its negative effects on implantation and pregnancy outcomes make it unsuitable during IVF embryo transfer cycles. The most recent and highest quality evidence demonstrates clear risks to clinical pregnancy rates when used during embryo transfer cycles. Until further research clarifies optimal timing and dosing, patients undergoing IVF should avoid resveratrol supplementation during the critical phases of embryo transfer and early pregnancy.