Melatonin is a naturally occurring hormone produced primarily by the pineal gland, known for regulating the body’s sleep-wake cycle. It is also a commonly used dietary supplement in fertility treatment, particularly for women undergoing assisted reproductive technologies like in vitro fertilization (IVF). Fertility specialists may recommend melatonin to optimize the reproductive environment, focusing on its protective cellular properties. The use of any supplement during an IVF cycle requires guidance from a reproductive endocrinologist.
Role of Melatonin in Enhancing Egg Quality
Melatonin is frequently recommended during IVF preparation due to its potent activity as a free radical scavenger. Oocyte (egg) maturation generates reactive oxygen species (ROS), which cause oxidative stress that negatively impacts the developing egg. Melatonin neutralizes these damaging molecules, creating a stable microenvironment within the ovarian follicle where the egg develops.
The hormone is naturally detected within the follicular fluid surrounding the egg, and higher concentrations often correlate with more mature, higher-quality oocytes. Supplementation boosts these local concentrations, providing enhanced protection. Melatonin also supports mitochondrial function inside the egg cell, which provides the energy necessary for successful fertilization and early embryo development. By mitigating oxidative damage and supporting energy production, melatonin aims to improve oocyte maturity, fertilization rates, and the quality of resulting embryos.
Typical IVF Protocol for Melatonin Use
The typical goal of melatonin supplementation is to improve oocyte quality before egg retrieval. To achieve this, specialists commonly recommend pre-treatment lasting one to three months before the ovarian stimulation phase begins. This timeline covers the final stages of follicular development, which take approximately 90 days.
The most common dosage prescribed in an IVF setting is 3 milligrams (mg) taken nightly, typically 30 to 60 minutes before bedtime. Some clinical studies have explored dosages ranging from 3 mg up to 6 mg daily. The precise timing and dose must always be determined by a fertility specialist, as melatonin can affect other reproductive processes, such as ovulation in non-IVF cycles.
Determining When to Cease Supplementation
When to stop taking melatonin during an IVF cycle depends heavily on the clinic’s specific protocol and the stage of treatment. Melatonin’s primary benefit is protecting the developing egg, so the initial objective is often achieved by the time of egg retrieval. Some clinics advise stopping the supplement on the day of the human chorionic gonadotropin (hCG) trigger shot, which occurs approximately 36 hours before the egg retrieval.
Other protocols recommend continuing melatonin past retrieval and through the embryo transfer, especially in a fresh cycle, to potentially aid implantation. This is based on the idea that the hormone may stabilize the corpus luteum and promote a healthy uterine environment. Clinical opinion varies widely, and some centers do not use melatonin after egg retrieval at all.
For patients proceeding to a fresh or frozen embryo transfer (FET), a common stopping point is the day of the transfer or immediately after the two-week wait is complete. The rationale for stopping is the lack of extensive long-term safety data for high-dose or prolonged melatonin use in early human pregnancy.
Once a positive pregnancy test is confirmed, the universal recommendation is to stop taking melatonin unless explicitly instructed otherwise. Although melatonin is naturally present in the body and levels increase during pregnancy, the dosage in over-the-counter supplements exceeds physiological amounts. The consensus is to exercise caution and discontinue the supplement during the first trimester due to limited evidence regarding the safety of exogenous supplementation for the developing fetus.
Safety Considerations and Monitoring During Treatment
Melatonin generally has a benign safety profile when used short-term at typical therapeutic doses. The most common side effects are usually mild and may include drowsiness, vivid dreams, nausea, or headache. These side effects are often manageable, but any unusual or severe reaction should be reported to the medical team.
Patients must maintain full transparency with their fertility specialist regarding all supplements and medications they are taking. This disclosure is necessary to monitor for potential drug-supplement interactions that could interfere with the hormonal balance of the IVF cycle. While melatonin is widely available without a prescription, its use in an IVF protocol transforms it into a medically managed treatment. The lack of long-term data on supplemental melatonin during pregnancy reinforces the importance of adhering precisely to the prescribed stopping date.