Autophagy activation in granulosa cells as a mechanism of astaxanthin action: evidence from a pilot randomised trial in PMOS-associated infertility.

TL;DR

In a pilot randomized trial of astaxanthin supplementation in women with PMOS-associated infertility, astaxanthin increased autophagy-related gene expression in granulosa cells and improved markers of oocyte maturity and embryo quality compared to placebo.

Key findings

• Astaxanthin increased ATG7 expression and enhanced autophagy flux while reducing apoptosis in granulosa cells, with a trend toward AMPK activation
• After adjustment for age, BMI, and AMH level, astaxanthin significantly increased total oocyte yield, MII oocyte yield, top-ranking embryo rate, and embryos suitable for cryopreservation
• Pregnancy outcomes were numerically higher with astaxanthin but did not reach statistical significance
• This pilot study suggests autophagy activation in granulosa cells may be a mechanism by which astaxanthin enhances oocyte competence and embryo quality in PMOS

Why this matters at the bedside

The findings suggest potential benefit of astaxanthin supplementation for improving oocyte and embryo outcomes in women with PMOS undergoing fertility treatment, with a proposed mechanistic basis through autophagy modulation in granulosa cells.