Lesoine Bernd, Regidor Pedro-Antonio
Centre for Reproductive Medicine, Prinzregentenstraße 69, Bogenhausen, 81675 Munich, Germany.
Frauenklinik München West, Schmiedwegerl 2-6, 81241 Munich, Germany.
Int J Endocrinol. 2016;2016:4378507. doi: 10.1155/2016/4378507. Epub 2016 Aug 22.
Polycystic ovarian syndrome (PCOS) is one of the pathological factors involved in the failure of in vitro fertilization (IvF). The aim of the present study was to investigate if the combination of myoinositol + folic acid was able to improve the oocyte quality, the ratio between follicles and retrieved oocytes, the fertilization rate, and the embryo quality in PCOS patients undergoing IvF treatments. 29 patients with PCOS underwent IvF protocols for infertility treatment and were randomized prospectively into two groups. Group A (placebo) with 15 patients and group B (4000 mg myoinositol + 400 μg folic acid per day) with 14 patients. The patients of group B used for two months myoinositol + folic acid before starting the IvF protocol and data were obtained concerning number of follicles, number of oocytes, quality of oocytes, fertilization rates, and embryo quality in both groups. The ratio follicle/retrieved oocyte was better in the myoinositol group (= group B). Out of the 233 oocytes collected in the myoinositol group 136 were fertilized, whereas only 128 out of 300 oocytes in the placebo group were fertilized. More metaphase II and I oocytes were retrieved in relation to the total amount of oocytes in the myoinositol. More embryos of grade I quality were obtained in the myoinositol. The duration of stimulation was 9,7 days (±3,3) in the myoinositol group and 11,2 (±1,8) days in the placebo group and the number of used FSH units was lower in the myoinositol group: 1750 FSH units (mean) versus 1850 units (mean). Our evidence suggests that myoinositol therapy in women with PCOS results in better fertilization rates and a clear trend to a better embryo quality. As the number of retrieved oocytes was smaller in the myoinositol group, the risk of hyper stimulation syndrome can be reduced in these patients.
多囊卵巢综合征（PCOS）是体外受精（IVF）失败的病理因素之一。本研究的目的是调查肌醇+叶酸联合使用是否能够改善接受IVF治疗的PCOS患者的卵母细胞质量、卵泡与回收卵母细胞的比例、受精率和胚胎质量。29例PCOS患者接受IVF方案进行不孕症治疗，并前瞻性随机分为两组。A组（安慰剂组）15例患者，B组（每天4000毫克肌醇+400微克叶酸）14例患者。B组患者在开始IVF方案前使用肌醇+叶酸两个月，并获取两组患者的卵泡数量、卵母细胞数量、卵母细胞质量、受精率和胚胎质量数据。肌醇组（即B组）的卵泡/回收卵母细胞比例更好。在肌醇组收集的233个卵母细胞中，有136个受精，而安慰剂组300个卵母细胞中只有128个受精。相对于肌醇组卵母细胞总量，回收的中期II和I期卵母细胞更多。在肌醇组获得了更多I级质量的胚胎。肌醇组的刺激持续时间为9.7天（±3.3），安慰剂组为11.2天（±1.8），肌醇组使用的促卵泡生成素（FSH）单位数量更低：平均1750个FSH单位，而安慰剂组平均为1850个单位。我们的证据表明，PCOS女性接受肌醇治疗可获得更好的受精率，且胚胎质量有明显改善趋势。由于肌醇组回收的卵母细胞数量较少，这些患者发生卵巢过度刺激综合征的风险可以降低。
