Center for Diagnosis and Treatment of Human Reproduction (SSD), Perugia Hospital, Perugia, Italy.
Eur Rev Med Pharmacol Sci. 2013 Nov;17(22):3095-102.
Nuclear and cytoplasmic competence of human oocyte is critical for future competence of the embryo upon which ultimately depends the outcome of an ART (Assisted Reproductive Technology) treatment. Follicular microenvironment in which the oocyte develops is crucial, and this must be taken into account particularly with the use of hormonal ovarian stimulation protocols. Inositol is an important element of the follicular environment and data support that its higher level in follicular fluid correlates with the development of a good oocyte. Aim of this study is to understand the effects of treatment with inositol on oocyte quality in a sample of patients undergoing ICSI (Intracytoplasmic Sperm Injection).
Assessment of oocyte/embryo quality and pregnancy rates in 149 patients divided, according to a controlled randomized pattern, into two groups: study group 1 treated with folic acid and inositol and control group 2 treated with folic acid alone.
The number of patients with excellent and good oocyte quality appears to be significantly higher in group 1 (p = 0.02), as shown, they significantly increased the number of embryos of grade A transferred in the group 1 (p = 0.02) compared to group 2, despite being completely similar averages of total embryos transferred (total mean ± SD = 2.4 ± 0.8, group 1 mean ± SD = 2.4 ± 0.8, group 2 mean ± SD = 2.4 ± 0.8). There is not any significant difference between groups 1 and 2 in the number of positivity to β-hCG and in the number of biochemical pregnancies detected although it has a tendency to increase in the first and to decrease in the second for group 1. The increase in percentage of clinical pregnancies in group 1 was statistically significant (p = 0.02), whereas there was no apparent significance in the difference between the biochemical and clinical pregnancies in the two groups despite the positive trend in the study group.
Relying on "inositol help" to solidify our efforts, seems to be an easy path to help to deepen the effectiveness of its use in all patients still under 40 but with prior failed attempts at ICSI or diagnosed with PCOS or as "poor responders".
人类卵子的核和细胞质能力对于胚胎未来的能力至关重要，而胚胎的能力最终决定了辅助生殖技术（ART）治疗的结果。卵子发育所处的卵泡微环境至关重要，特别是在使用激素卵巢刺激方案时，必须考虑到这一点。肌醇是卵泡环境的重要组成部分，数据支持卵泡液中肌醇水平较高与优质卵子的发育相关。本研究旨在了解在接受胞浆内单精子注射（ICSI）的患者样本中，肌醇治疗对卵子质量的影响。
根据对照随机分组模式，将 149 名患者分为两组：研究组 1 接受叶酸和肌醇治疗，对照组 2 仅接受叶酸治疗。评估卵子/胚胎质量和妊娠率。
第 1 组优质和良好卵子数量明显高于第 2 组（p = 0.02），尽管两组总胚胎转移的平均水平完全相似（总平均±SD=2.4±0.8，第 1 组平均±SD=2.4±0.8，第 2 组平均±SD=2.4±0.8），但第 1 组转移的 A 级胚胎数量明显增加（p = 0.02）。第 1 组β-hCG 阳性率和生化妊娠率检测无明显差异，但第 1 组有增加趋势，第 2 组有减少趋势。第 1 组临床妊娠率增加具有统计学意义（p = 0.02），尽管研究组呈阳性趋势，但两组生化妊娠和临床妊娠之间的差异无明显意义。
依靠“肌醇帮助”巩固我们的努力，似乎是一种简单的途径，可以帮助深化其在所有年龄仍在 40 岁以下但先前 ICSI 尝试失败或诊断为 PCOS 或“反应不良”的患者中的使用效果。
