Center for Reproductive Medicine Research, Clinica Villa Mafalda, Rome, Italy.
Reprod Biol Endocrinol. 2012 Jul 23;10:52. doi: 10.1186/1477-7827-10-52.
Aim of this pilot study is to examine the effects of myo-inositol administration on ovarian response and oocytes and embryos quality in non PolyCystic Ovary Syndrome (PCOS) patients undergoing multiple follicular stimulation and in vitro insemination by conventional in vitro fertilization or by intracytoplasmic sperm injection.
One hundred non-PCOS women aged <40 years and with basal FSH <10 mUI/ml were down-regulated with triptorelin acetate from the mid-luteal phase for 2 weeks, before starting the stimulation protocol for oocytes recovery. All patients received rFSH, at a starting dose of 150 IU for 6 days. The dose was subsequently adjusted according to individual response. Group B (n=50) received myo-inositol and folic acid for 3 months before the stimulation period and then during the stimulation itself. Group A (n-50) received only folic acid as additional treatment in the 3 months before and through treatment.
Total length of the stimulation was similar between the two groups. Nevertheless, total amount of gonadotropins used to reach follicular maturation was found significantly lower in group B. In addition, the number of oocytes retrieved was significantly reduced in the group pretreated with myo-inositol. Clinical pregnancy and implantation rate were not significantly different in the two groups.
Our findings suggest that the addition of myo-inositol to folic acid in non PCOS-patients undergoing multiple follicular stimulation for in-vitro fertilization may reduce the numbers of mature oocytes and the dosage of rFSH whilst maintaining clinical pregnancy rate. Further, a trend in favor of increased incidence of implantation in the group pretreated with myo-inositol was apparent in this study. Further investigations are warranted to clarify this pharmacological approach, and the benefit it may hold for patients.
本研究旨在探讨肌醇在非多囊卵巢综合征（PCOS）患者接受多个卵泡刺激和体外受精或卵胞浆内单精子注射常规体外受精中对卵巢反应和卵子及胚胎质量的影响。
100 名年龄<40 岁且基础 FSH<10 mUI/ml 的非 PCOS 妇女在黄体中期用醋酸曲普瑞林下调 2 周，然后开始恢复卵母细胞的刺激方案。所有患者均接受 rFSH，起始剂量为 150IU，持续 6 天。随后根据个体反应调整剂量。B 组（n=50）在刺激期前 3 个月开始接受肌醇和叶酸治疗，然后在刺激期间继续治疗。A 组（n=50）仅在刺激前 3 个月和治疗期间接受叶酸作为额外治疗。
两组的刺激总时长相似。然而，达到卵泡成熟所需的促性腺激素总量在 B 组中明显较低。此外，用肌醇预处理的组中取回的卵子数量明显减少。两组的临床妊娠率和着床率无显著差异。
我们的发现表明，在接受多个卵泡刺激以进行体外受精的非 PCOS 患者中，将肌醇添加到叶酸中可能会减少成熟卵子的数量和 rFSH 的剂量，同时保持临床妊娠率。此外，本研究中，用肌醇预处理的组中着床率增加的趋势明显。需要进一步的研究来阐明这种药物治疗方法及其对患者的益处。
