How Astaxanthin Support Women’s Fertility: New Insights from a 2026 Trial

Female fertility depends on more than the number of eggs available. The health of the cells surrounding each developing egg also matters.

A 2026 clinical study published in Human Fertility explored whether astaxanthin could support these ovarian cells in women with polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS). The findings suggest that astaxanthin may help improve cellular quality-control processes linked to egg maturity and embryo quality, although larger trials are still needed.

Why Granulosa Cells Matter for Fertility

Granulosa cells surround and support a developing egg inside the ovarian follicle. They help supply nutrients, regulate hormones, manage cellular stress, and support the egg as it matures.

In women with PMOS-related infertility, granulosa cells may experience increased oxidative stress, mitochondrial dysfunction, and apoptosis, a form of programmed cell death. These changes may affect egg competence even when the ovaries produce a high number of follicles.

Researchers are therefore studying ways to support granulosa-cell health during assisted reproductive treatment.

The Role of Autophagy

One process receiving growing attention is autophagy. The term means “self-eating,” but it is better understood as the cell’s internal recycling and maintenance system.

Through autophagy, cells break down damaged components and reuse useful materials. Healthy autophagy helps granulosa cells maintain energy balance, respond to stress, and support normal follicle and egg development. When this process is disrupted, damaged cellular material may accumulate and interfere with ovarian function.

What the 2026 Study Examined

Maleki-Hajiagha, Aleyasin, and Amidi (2026) conducted a triple-blind, placebo-controlled pilot randomized trial involving women with PMOS-related anovulatory infertility who were undergoing assisted reproductive technology.

Fifty women were enrolled, and 44 completed the study. Participants received either:

• 12 mg of astaxanthin daily for six weeks before egg retrieval, or

• An identical placebo.

The researchers assessed markers of autophagy and apoptosis in granulosa cells collected during egg retrieval. They also compared ovarian response, egg maturity, cleavage-stage embryo quality, and pregnancy outcomes.

What Did the Researchers Find?

Astaxanthin supported cellular recycling

The astaxanthin group showed changes in several biological markers consistent with increased autophagy. These included higher ATG7 gene expression, increased LC3-II levels, a higher LC3-II-to-LC3-I ratio, and greater autophagic flux.

Autophagic flux reflects how actively cellular material moves through the recycling pathway. This is important because it indicates that the process is functioning dynamically rather than simply accumulating markers.

Apoptosis markers were reduced

The study also found lower levels of cleaved PARP, a marker associated with apoptosis, in the astaxanthin group. Together, the molecular findings suggest that astaxanthin may help granulosa cells maintain healthier quality-control and survival pathways.

More mature eggs were retrieved

After adjusting for age, body mass index, and anti-Müllerian hormone levels, the astaxanthin group had a higher average total egg yield and more mature metaphase II eggs than the placebo group.

Adjusted averages showed 20.4 mature eggs in the astaxanthin group compared with 15.6 in the placebo group. However, the egg maturity rate itself was no longer statistically significant after adjustment.

Embryo-quality measures improved

The rate of top-ranking cleavage-stage embryos was higher with astaxanthin. After adjustment, participants taking astaxanthin also had more embryos suitable for cryopreservation, with an adjusted average of 12.7 compared with 9.6 in the placebo group.

The total number of embryos did not differ significantly between groups. This suggests that the possible benefit may relate more to developmental competence and embryo quality than simply embryo quantity.

Did Astaxanthin Improve Pregnancy Rates?

Pregnancy outcomes were numerically higher in the astaxanthin group, but the differences were not statistically significant. The trial was small and was not designed to determine whether astaxanthin improves pregnancy or live-birth rates. Live-birth outcomes were not available.

For this reason, the study does not prove that astaxanthin increases the chance of becoming pregnant. It provides preliminary evidence of a possible cellular mechanism and improvements in selected egg and embryo measures among women with PMOS undergoing fertility treatment.

Safety and Important Limitations

No adverse effects or toxicity related to astaxanthin were reported during the six-week intervention. However, the findings apply to a specific clinical population and should not be generalized to all women trying to conceive.

The study included only 44 participants in its final analysis. It excluded women with a body mass index above 35 and those using insulin-sensitizing medications. Its molecular analyses were exploratory and were not adjusted for multiple comparisons. Larger, longer studies are needed to confirm the results and evaluate pregnancy and live-birth outcomes.

Anyone considering astaxanthin during fertility treatment, pregnancy, or breastfeeding should first speak with a reproductive specialist or healthcare professional.

Final Takeaway

This pilot trial offers an early look at how astaxanthin may support women’s reproductive health at the cellular level. By promoting autophagy and reducing apoptosis in granulosa cells, astaxanthin may help create a healthier environment for egg maturation and early embryo development in women with PMOS undergoing assisted reproduction.

The results are promising, but preliminary. Astaxanthin should be viewed as an area of active research, not as a treatment for infertility or a substitute for individualized medical care.

Put the science into practice with Astadaily® Astaxanthin Pure, a clean, single-ingredient source of natural astaxanthin that can be easily incorporated into your daily routine.

References

Maleki-Hajiagha, A., Aleyasin, A., & Amidi, F. (2026). Autophagy activation in granulosa cells as a mechanism of astaxanthin action: Evidence from a pilot randomised trial in PMOS-associated infertility. Human Fertility, 29(1), Article 2689659. https://doi.org/10.1080/14647273.2026.2689659