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Pregnancy and Fertility


A review of the available literature by obstetric researchers found that because pregnancy has increased oxygen demands on the body and, thus, more free radical damage, melatonin supplementation may be a critical consideration for both complicated and normal pregnancies, counter to the traditional stance of avoiding it during pregnancy (1). According to some research, the use of melatonin supplementation during pregnancy, which has been found safe in both mother and fetus according to some research, could prove to help limit complications during critical periods before and shortly after delivery (2,3). A study suggested that preeclampsia does not have a seasonal variation, although it was observed that reduced melatonin levels were associated with the development of preeclampsia (3). Therefore, it has been suggested that melatonin may help support a successful pregnancy.


Pregnancy is a critical time for fetal programming of hypertension. As an antioxidant therapy, melatonin may help prevent hypertension in the offspring of patients with a family history of hypertension (4). It has been hypothesized that oxidative stress negatively impacts fertility. Since melatonin is a strong scavenger of oxidative factors, it could improve both male and female fertility and sperm and oocyte quality, resulting in increased fertilization (5–8). Melatonin shows promise for advanced age infertility and improving IVF outcomes (9–13).


Delivery by cesarean may also be associated with higher levels of pro-inflammatory cytokines compared to vaginal birth (14), thereby shunting the production of pineal gland melatonin synthesis and upregulating the tryptophan conversion into the kynurenic pathway, offsetting the serotonin-melatonin pathway (15). Women who delivered vaginally versus by cesarean had higher colostrum melatonin levels (14,16). Finally, administering 10 mg of melatonin, compared with 5 mg or placebo, to women before the cesarean section with spinal anesthesia was shown to reduce the severity of their pain, duration of analgesic use postoperatively, and facilitated their ability to be more physically active in less time after surgery (17).


Authors: Deanna Minich, Ph.D., Melanie Henning, ND, Catherine Darley, ND, Mona Fahoum, ND, Corey B. Schuler, DC, James Frame

Reviewer: Peer-review in Nutrients Journal

Last updated: September 22, 2022



1. Wilkinson D, Shepherd E, Wallace EM. Melatonin for women in pregnancy for neuroprotection of the fetus. Vol. 2016, Cochrane Database of Systematic Reviews. 2016.

2. Aversa S, Pellegrino S, Barberi I, Reiter RJ, Gitto E. Potential utility of melatonin as an antioxidant during pregnancy and in the perinatal period. Vol. 25, Journal of Maternal-Fetal and Neonatal Medicine. 2012.

3. Zeng K, Gao Y, Wan J, Tong M, Lee AC, Zhao M, et al. The reduction in circulating levels of melatonin may be associated with the development of preeclampsia. J Hum Hypertens. 2016;30(11).

4. Ivanov DO, Evsyukova II, Mironova ES, Polyakova VO, Kvetnoy IM, Nasyrov RA. Maternal melatonin deficiency leads to endocrine pathologies in children in early ontogenesis. Vol. 22, International Journal of Molecular Sciences. 2021.

5. Soleimani Rad S, Abbasalizadeh S, Ghorbani Haghjo A, Sadagheyani M, Montaseri A, Soleimani Rad J. Serum Levels of Melatonin and Oxidative Stress Markers and Correlation between Them in Infertile Men. J Caring Sci. 2013;2(4).

6. Rad SS, Abbasalizadeh S, Haghjo AG, Sadagheyani M, Montaseri A, Rad JS. Evaluation of the melatonin and oxidative stress markers level in serum of fertile and infertile women. Iran J Reprod Med. 2015;13(7).

7. Kratz EM, Piwowar A, Zeman M, Stebelová K, Thalhammer T. Decreased melatonin levels and increased levels of advanced oxidation protein products in the seminal plasma are related to male infertility. Reprod Fertil Dev. 2016;28(4).

8. Kratz EM, Piwowar A. Melatonin, advanced oxidation protein products and total antioxidant capacity as seminal parameters of prooxidant-antioxidant balance and their connection with expression of metalloproteinases in context of male fertility. Vol. 68, Journal of Physiology and Pharmacology. 2017.

9. Olcese JM. Melatonin and Female Reproduction: An Expanding Universe. Vol. 11, Frontiers in Endocrinology. 2020.

10. Berbets AM, Davydenko IS, Barbe AM, Konkov DH, Albota OM, Yuzko OM. Melatonin 1A and 1B Receptors’ Expression Decreases in the Placenta of Women with Fetal Growth Restriction. Reproductive Sciences. 2021;28(1).

11. Fernando S, Rombauts L. Melatonin: Shedding light on infertility? - A review of the recent literature. Journal of Ovarian Research. 2014.

12. Bao Z, Li G, Wang R, Xue S, Zeng Y, Deng S. Melatonin Improves Quality of Repeated-Poor and Frozen-Thawed Embryos in Human, a Prospective Clinical Trial. Front Endocrinol (Lausanne). 2022 May 13;13.

13. Zhu Q, Wang K, Zhang C, Chen B, Zou H, Zou W, et al. Effect of melatonin on the clinical outcome of patients with repeated cycles after failed cycles of in vitro fertilization and intracytoplasmic sperm injection. Zygote. 2022;

14. Çallśkan C, Çelik S, Hatirnaz S, Çelik H, Avcl B, Tinelli A. The Role of Delivery Route on Colostrum Melatonin and Serum Il-6 Levels: A Prospective Controlled Study. Z Geburtshilfe Neonatol. 2021;225(6).

15. Trifu S, Vladuti A, Popescu A. The neuroendocrinological aspects of pregnancy and postpartum depression. Acta Endocrinol (Copenh). 2019;15(3).

16. Namll Kalem M, Kalem Z, Yuce T, Baklrarar B, Söylemez F. Comparison of Melatonin Levels in the Colostrum between Vaginal Delivery and Cesarean Delivery. Am J Perinatol. 2018;35(5).

17. Kiabi FH, Emadi SA, Jamkhaneh AE, Aezzi G, Ahmadi NS. Effects of preoperative melatonin on postoperative pain following cesarean section: A randomized clinical trial. Annals of Medicine and Surgery. 2021;66.

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