Myo-inositol therapy for poor-responders during IVF: a prospective controlled observational trial

Abstract

BackgroundThe overall incidence of poor ovarian response in IVF cycles has been reported to be between 9 and 24 %. The management of these patients remains a significant challenge in assisted reproduction. The aim of the present study was to evaluate the effect of myo-inositol (MI) on ovarian function in poor responders undergoing ICSI.MethodsThe study is a prospective controlled observational trial, that involved 72 poor responders included in an ICSI program and divided into two groups; group A: 38 patients who have been assuming MI (4 g) + folic acid (FA) (400 μg) for the previous 3 months before the enrollment day; group B: 38 patients assuming FA (400 μg) alone for the same period. COH was carried out in the same manner in the two groups. The main goal was the assessment of oocytes retrieved number and quality; secondary endpoints were the Ovarian Sensitivity Index (OSI: n° oocytes retrieved/total Gonadotropins units × 1000), oestradiol levels on the day of hGC, fertilization rate, implantation rate, ongoing pregnancy rate.ResultsThere was no significant difference between the two groups regarding oestradiol level, but total rec-FSH units were significantly lower (p = 0.004) and M2 oocytes rate significantly higer (p = 0.01) in group A. The ovarian sensitivity index was higher, reaching a statistical significance (p < 0.05), in the group of patients pre-treated with MI, showing an improvement in ovarian sensibility to gonadotropin.ConclusionsOur results suggest that MI therapy in poor responders results in an increased of the number of oocytes recovered in MII and of the gonadotropin Ovarian Sensitivity Index (OSI), suggesting a MI role in improving ovarian response to gonadotropins. Therefore MI seems to be helpful in “poor responders” undergoing IVF cycles.

A Double-Blind, Randomized Prospective Study to Evaluate the Efficacy of Previous Therapy With Melatonin, Myo-inositol, Folic Acid, and Selenium in Improving the Results of an Assisted Reproductive Treatment

“…Therefore, the presence of folic acid in the body is essential for adequate cell division and duplication. 28 Supplementation with antioxidants to improve oocyte quality is a controversial subject that has not yet been fully resolved, and, regarding which, there are several opinions, both favorable 18,26 and unfavorable. 29 With this study, we intended to establish the events occurring with a complex of antioxidants selected in the daily practice of a reproduction clinic.…”

Myo-Inositol

“…Vereinzelte Untersuchungen haben Myo-Inositol auch bei den etwa 10-20 % der sog. "poor responders" in IVF-Zyklen getestet und eine vermehrte Gewinnung von Eizellen sowie eine Verbesserung des Ovarsensitivitätsindex festgestellt [7].…”

Inositol and Women Reproductive Health

“…Zayıf over yanıtının genel insidansı %9-24 arasında değişmektedir. 10 Bununla birlikte birçok çift artık erken yaşlarda anne baba olmak istememektedir bu nedenle Amerika Birleşik Devletleri'nde ilk kez anne olan kadınların yaş ortalaması son 36 yılda 21,4'ten 25,0 yıla yükselmiştir. 9 Tür-kiye Sağlık İstatistikleri 2014 verilerine göre kadınların en çok 25-29 yaşları arasında doğum yaptıkları belirlenmiştir.…”

“…Çalışma sonunda östrodial düzeyi gruplar arasında farklılık göstermez iken, olgun oosit düzeyi ve ovaryan duyarlılık indeksi inositol+FA alan grupta daha yük-sek bulunmuştur. 10 ICSI uygulanan bireylerde yapılan benzer bir çalışmada, inositol tedavisinin oosit kalitesi üzerine etkisini değerlendirmek amaçlanmış ve çalışmada bireyler iki gruba ayrıl-mıştır. Üç ay boyunca ilk gruba (n=58) inositol ve FA (2.000 mg/gün MI, 400 mg/gün DCI ve 400 mg/gün FA); ikinci gruba (n=91) yalnızca FA (400 mg/gün) verilmiştir.…”