Antioxidant therapy in endometriosis treatment: systematic review

ABSTRACT

Objective. To summarize current knowledge on the effectiveness of antioxidant therapy in endometriosis treatment.

Materials and Methods. A systematic review was conducted per PRISMA guidelines and registered in PROSPERO 2023 CRD42023454705. Studies published until November 2024 were identified through PubMed, The Cochrane Library, ClinicalTrials.gov, Google Scholar, and MEDLINE. COVIDENCE software was used for screening. Risk of bias was assessed using the Cochrane Handbook.

Results. Out of 512 studies, 11 were included in the systematic review. Endometriotic cysts weight and volume are dose-dependent parameters that are significantly lower in antioxidant treatment groups (p <0.05) Neither histological cell scores nor trichrome fibrosis scores showed statistically significant differences among treatment and control groups (p > 0.05) in 2 out of 3 studies. Significantly lower levels of TOS, NO and OSI are evaluated in the antioxidant group compared to control. However, no significant differences were observed in MDA, SOD and CAT levels. The number of follicles was significantly increased, and the atretic follicles number was significantly decreased after therapy (p <0.05). The IVF, cleavage, blastocyst formation rates and blastocyst number were significantly higher in treatment group compared the control.

Conclusions. Antioxidants may be considered as a possible component of endometriosis therapy to potentially enhance fertility outcomes and slow disease progression, though current evidence is preliminary and requires further validation.