Improvement in quality of oocytes in polycystic ovarian syndrome in programs of in vitro fertilization

Abstract

Inositol therapy is aimed at improving the quality of oocytes during preconception care in patients with polycystic ovarian syndrome (PCOS), a cause of infertility and reproductive dysfunction. The objectives of this observational comparative multicentre study were to evaluate the effectiveness of inositol in improving the quality of oocytes/embryos and IVF cycle outcome. Group 1 patients (N ¼ 133) received inositol 1000 mg (Inofert or Nutrilinea) þ folic acid 0.1 mg. Group 2 consisted of patients with preserved ovarian reserve without PCOS (N ¼ 137), not administered inositol prior to pregnancy. Effectiveness criteria were numbers of mature oocytes and good quality embryos, pregnancy rates per ET, 'take home baby' index and miscarriage rates. Pregnancy rates per ET (87.0% vs. 87.4%), 'take home baby' index (79.6% vs. 89.4%) and miscarriage rates (14.3% vs. 10.6%) were comparable. Use of inositol in patients with PCOS during preconception care is an effective method allowing improvement of oocytes quality and positively affecting IVF cycle prognosis. High pregnancy rates per ET and 'take home baby' index after treatment are justifying inositol usage in patients with PCOS and infertility.ARTICLE HISTORY

Inositols: From Established Knowledge to Novel Approaches

“…Further demonstrations of myo-Ins efficacy came from two other studies: the first is an IVF clinical trial on 133 PCOS women [135], in which the authors reported that supplementation with 1 g myo-Ins and 400 µg folic acid significantly augmented the number of mature oocytes compared to the control group, treated with folic acid and cyanocobalamin. In the second prospective, controlled, randomized trial by Özay and colleagues, the clinicians provided a supplement of 4 g myo-Ins and 400 µg folic acid to 98 infertile PCOS patients undergoing controlled ovarian hyperstimulation with rFSH and intrauterine insemination [136].…”

Melatonin and Myo-Inositol: Supporting Reproduction from the Oocyte to Birth

“…A wealth of information regarding the importance of myo-ins in the ovaries comes from studies in pathological scenarios that lead to the need for assisted fertilization protocols. In particular, evidence derives from studies on patients with PCOS, the most common endocrinological syndrome in women of reproductive age, which leads to lower quality and maturity of oocytes and to consequently lower quality of embryos [40]. PCOS is often characterized by alterations of the inositol profile, both at ovarian and at global levels [41].…”

Combination of alpha lipoic acid and metformin supplement improve assisted reproductive technologies outcomes in polycystic ovary syndrome patients

“…Nevertheless, these oocytes are often of low quality, leading to low fertilization, cleavage, and implantation. In most cases, treatment with some drugs overcomes anovulation associated with PCOS, leading to reductions in risk factors, and improves the response to ovulation induction [ 8 ]. Antioxidant supplements have been shown to improve insulin sensitivity and other health-threatening conditions in women with PCOS.…”

“…Antioxidant supplements have been shown to improve insulin sensitivity and other health-threatening conditions in women with PCOS. Despite the important role of alternative medicine, especially antioxidants, in the management of PCOS in women [ 8 ], there are not many well-designed studies reported in the literature, especially in Iran. On the other hand, existing studies on the use of antioxidants in PCOS women have yielded controversial results due to the sample size or variations in the antioxidants prescribed or the outcomes evaluated in them.…”