Department of Obstetrics and Gynecology, University of Messina, Messina, Italy.
Eur Rev Med Pharmacol Sci. 2010 Jun;14(6):555-61.
The aim of the study was to evaluate the efficacy of a treatment with myo-inositol plus folic acid plus melatonin compared with myo-inositol plus folic acid alone on oocyte quality in women underwent in vitro fertilization (IVF) cycles.
A prospective, clinical trial.
Starting on the day of GnRH administration, 65 women undergoing IVF cycles were randomized in two groups to receive myo-inositol plus folic acid plus melatonin (32 women, group A), and myo-inositol plus folic acid (33 women, group B), administered continuously. Primary endpoints were number of morphologically mature oocytes retrieved (MII oocytes), embryo quality, and pregnancy rate. Secondary endpoints were the total number of oocytes retrieved (immature and mature oocytes), fertilization rate per number of retrieved oocytes and embryo cleavage rate.
The mean number of oocytes retrieved did not differ between the two groups (7.88 +/- 1.76 vs 7.67 +/- 1.88; P=0.65). Whereas the group cotreated with melatonin reported a significantly greater mean number of mature oocytes (6.56 +/- 1.64 vs 5.76 +/- 1.56; P=0.047) and a lower mean number of immature oocytes (1.31 +/- 0.74 vs. 1.91 +/- 0.68; P=0.001). The mean number of embyos of top-quality (class 1 and 2) resulted higher in the group A (1.69 +/- 0.64 vs 1.24 +/- 0.75; P=0.01). Fertilization rate did not differ between the two groups. A total of 22 pregnancies were obtained (13 in group A and 9 in group B; P=0.26). Clinical pregnancy rate and implantation rate were in tendency higher in the group cotreated with melatonin, although the differences did not reach statistical significance. Biochemical pregnancy rate and abortion rate were similar in both groups.
melatonin ameliorates the activity of myo-inositol and folic acid by improving oocyte quality and pregnancy outcome in women with low oocyte quality history.
本研究旨在评估肌醇联合叶酸加褪黑素治疗与单纯肌醇联合叶酸治疗对体外受精（IVF）周期中卵子质量的疗效。
前瞻性临床试验。
从 GnRH 给药日开始，将 65 名接受 IVF 周期的妇女随机分为两组，分别接受肌醇联合叶酸加褪黑素（32 名妇女，A 组）和肌醇联合叶酸（33 名妇女，B 组）连续治疗。主要终点是可获取的形态成熟卵母细胞（MII 卵母细胞）数量、胚胎质量和妊娠率。次要终点是可获取的卵母细胞总数（不成熟和成熟卵母细胞）、每枚获取卵母细胞的受精率和胚胎卵裂率。
两组获取的卵母细胞数量无显著差异（7.88 ± 1.76 与 7.67 ± 1.88；P=0.65）。然而，接受褪黑素联合治疗的组报告说，成熟卵母细胞的平均数量显著增加（6.56 ± 1.64 与 5.76 ± 1.56；P=0.047），而不成熟卵母细胞的平均数量减少（1.31 ± 0.74 与 1.91 ± 0.68；P=0.001）。A 组优质胚胎（1 级和 2 级）的平均数量更高（1.69 ± 0.64 与 1.24 ± 0.75；P=0.01）。两组的受精率无显著差异。共获得 22 例妊娠（A 组 13 例，B 组 9 例；P=0.26）。尽管差异没有达到统计学意义，但接受褪黑素联合治疗的组妊娠率和种植率呈上升趋势。两组的生化妊娠率和流产率相似。
褪黑素通过改善低卵子质量史妇女的卵子质量和妊娠结局，改善肌醇和叶酸的活性。
