Melatonin Therapy for Improving ICSI Outcomes in Women With Diminished Ovarian Reserve

Preliminary Assessment of the Impact of Melatonin Therapy for Women With Diminished Ovarian Reserve on the Ovarian Reserve and the ICSI Outcomes

Diminished ovarian reserve (DOR) is a major challenge in female fertility, often leading to poor oocyte quality and low pregnancy rates during assisted reproduction. Melatonin is a potent antioxidant that may protect developing eggs from oxidative stress. This randomized clinical trial aims to evaluate whether a 4-week course of oral melatonin therapy before egg retrieval can improve the quality of oocytes and embryos, and ultimately increase pregnancy rates for women with DOR undergoing Intracytoplasmic Sperm Injection (ICSI). The study compares melatonin therapy against a placebo to assess its impact on follicular fluid health and clinical pregnancy success.

Inclusion Criteria:

• Confirmed Diminished Ovarian Reserve (DOR) based on Bologna criteria (e.g., low AMH, low AFC).
• Undergoing ICSI with frozen blastocyst transfer (FBT) protocol.
• Willingness to comply with a 28-day pre-retrieval medication regimen.

Exclusion Criteria:

• Severe endometriosis or hydrosalpinx.
• Uterine anomalies (e.g., large fibroids or uterine septums).
• Chronic systemic diseases (e.g., uncontrolled diabetes or hypertension).
• Partner with severe male factor infertility requiring TESE/PESA (to isolate the effect on oocyte quality).
• Current use of other antioxidant supplements.