Effect of Supplementation with Moringa oleifera on Antioxidant and Oxidative Stress Biomarkers of Infertile Women: A Pilot Open-Label Randomized Clinical Trial

Abstract

BACKGROUND: Excessive generation of free radicals has been reported to be associated with infertility. Clinical studies investigating the effect of supplementation with _Moringa oleifera (Lam)_ on antioxidant and oxidative stress markers of infertile women are deplete. This study aims to investigate the effects of supplementation with _Moringa oleifera_ on the antioxidant and oxidative stress markers of infertile women. METHODOLOGY: This study was an open-label randomized clinical trial. A total of 100 women, aged 35-50 years, attending Island Maternity Hospital, Lagos who were diagnosed of infertility were recruited and screened. Blood sample was collected at the follicular phase of the menstrual cycle for pre-enrollment fertility screening. Plasm levels of Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Prolactin and Estrogen (E2) were measured using Enzyme Linked Immunosorbent Assay (ELISA) technique. Of these numbers, 40 had elevated hormonal profile and were excluded. Sixty women with normal hormonal profile were randomized into two groups each comprising 30 subjects respectively. Thirty fertile women attending the same hospital were randomly selected. Five-milliliter of blood specimen was collected and used to assess the baseline of biomarkers between fertile and infertile women. The case group was supplemented with 2 g of MO capsules in divided doses daily for four weeks. The control group received no supplementation. After four weeks post-supplementation, plasma levels of Malondialdehyde (MDA), Total Plasma Peroxide (TPP), Lipid hydroperoxide (LPO), Total Antioxidant Capacity (TAC), Glutathione reductase (GR), and Glutathione (GSH) were reassessed using standard methods. The Oxidative Stress Index (OSI) was calculated using an approved conventional method. RESULTS: The mean levels of markers of oxidative stress (MDA, TPP, LPO, and OSI) were higher in infertile women than in the fertile group. However, only TPP and OSI were significantly higher (p ≤ 0.05). Levels of MDA, TPP, LPO, and OSI were lower in the supplemented group than in those unsupplemented (P>0.05). The levels of antioxidant biomarkers (TAC, GR, and GSH) were slightly higher in the infertile women supplemented with _Moringa oleifera_ than in the unsupplemented group (P>0.05). CONCLUSION: This study revealed that increase in oxidative stress biomarkers is associated with female infertility. Supplementation with _Moringa oleifera_ in infertile women could help reduce the effects of OS among infertile women and might likely improve pregnancy outcome.