Resveratrol supplementation and assisted reproduction outcomes: A systematic review and meta-analysis

Resveratrol is a mitochondrial-targeted nutraceutical with antioxidant and anti-aging properties that has been proposed as an adjuvant to optimize assisted reproductive technology (ART) outcomes. However, its clinical efficacy, optimal dosing, and applicability across different female reproductive profiles remain uncertain.

To evaluate the effects of resveratrol supplementation on reproductive outcomes in women undergoing ART compared with no resveratrol use, and to explore potential modifiers such as age, BMI, ovarian reserve, dosing, and treatment duration.

We conducted a systematic review and meta-analysis following Cochrane and PRISMA guidelines, with prospective registration in PROSPERO (CRD420251238442). PubMed, Embase, and Cochrane Central were searched up to November 2025 without language restrictions.

Eligible studies included randomized controlled trials (RCTs) and observational studies of women undergoing ART receiving resveratrol alone or with vitamins versus no resveratrol, reporting at least one reproductive outcome. Effect sizes were pooled using random-effects models according to heterogeneity.

Primary outcomes were defined as biochemical pregnancy rate (BPR), clinical pregnancy rate (CPR), and live birth rate (LBR). We also assessed as secondary outcomes the number of retrieved oocytes, mature oocytes, developed mature follicles (>16 mm), fertilization rate, number of embryos, serum dosage of gonadotropins, miscarriage rate (MR), and number of high-quality embryos.

A total of 7 studies were included in this systematic review and meta-analysis comprising 3.411 patients, of which 274 (8%) were supplemented with resveratrol. Resveratrol supplementation was associated with higher fertilization rates (MD 2.89; 95% CI 1.68 to 4.10; p<0.01; I²=0%). No significant differences were observed in the number of retrieved or mature oocytes, number of embryos, biochemical or clinical pregnancy, high-quality embryos, or live birth. Subgroup analysis suggested an increased number of mature oocytes in women < 35 years, whereas women ≥ 35 years showed no consistent benefit. Meta-regression indicated age-related declines in reproductive outcomes and only modest.

Despite statistically significant improvement in fertilization rates, resveratrol supplementation during assisted reproductive technology does not translate to higher pregnancy establishment or live birth rates. Evidence of age-dependent and dose-dependent effects requires confirmation in larger, better-designed trials.