Across 7 randomized and observational studies encompassing 3,411 women undergoing assisted reproductive technology (ART), resveratrol supplementation produced a statistically significant increase in fertilization rate (mean difference 2.89; 95% CI 1.68–4.10; p<0.01; I²=0%), with a subgroup signal favoring mature oocyte counts in women under 35. However, no meaningful improvements emerged in clinical pregnancy rate, biochemical pregnancy rate, live birth rate, oocyte retrieval, embryo count, or high-quality embryo formation.
The fertilization-without-pregnancy disconnect is the critical story here. A higher fertilization rate is biologically plausible given resveratrol's documented mitochondrial activation via SIRT1/AMPK pathways and its antioxidant reduction of oxidative stress in oocytes — mechanisms well-established in animal models. Yet the clinical chain breaks before implantation, suggesting resveratrol may improve early gamete function without addressing the downstream endometrial, embryonic, or immune factors that determine pregnancy success.
Several limitations substantially temper enthusiasm: only 274 of 3,411 participants (8%) actually received resveratrol, creating severe statistical imbalance; dosing protocols and treatment durations varied across trials; and the evidence base of 7 studies is too thin to draw firm conclusions. This meta-analysis is best read as confirmatory of biological plausibility rather than clinical utility. Until adequately powered RCTs with standardized dosing specifically targeting live birth rate are completed, resveratrol supplementation in ART cannot be recommended as standard adjuvant therapy.
