Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
IVF Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Gynecol Obstet Hum Reprod. 2020 May;49(5):101698. doi: 10.1016/j.jogoh.2020.101698. Epub 2020 Feb 1.
This study has evaluated the use of myo-inositol supplementation for improving reproductive outcomes in poor responders undergoing intracytoplasmic sperm injection (ICSI).
One hundred and twelve poor responder patients were included in the study and randomly categorized into two groups using a permuted block randomization method. Group A included 56 patients who received myo-inositol (4 g) and folic acid (400 μg) daily from one month before starting the ICSI cycle continuing until the ovulation triggering day. Group B included 56 patients consuming only folic acid (400 μg) daily for the same period. The outcome measures were the number of retrieved oocytes, embryo quality, Ovarian Sensitivity Index (OSI: number of oocytes retrieved/total Gonadotropins units × 1000), fertilization, implantation, and ongoing pregnancy rates.
No significant difference was observed between the two groups regarding the total dose of gonadotropin used, OSI, and the number of total retrieved and mature oocytes. Grad A embryos and fertilization rate were significantly increased in group A. Implantation and pregnancy rates showed statistically insignificant changes.
Treatment of poor responders with myo-inositol from one month before starting ICSI cycle continuing until ovulation trigger can improve fertilization rate and embryo quality, and may enhance the cumulative pregnancy rate in poor responders.
本研究评估了肌醇补充剂在接受胞浆内精子注射（ICSI）的不良反应者中改善生殖结局的应用。
本研究纳入了 112 名不良反应者患者，并采用区组随机化方法将其随机分为两组。A 组 56 例患者在开始 ICSI 周期前一个月开始每日服用肌醇（4 g）和叶酸（400 μg），持续至排卵诱发日。B 组 56 例患者同期仅每日服用叶酸（400 μg）。观察指标包括获卵数、胚胎质量、卵巢敏感指数（OSI：获卵数/总促性腺激素单位×1000）、受精率、着床率和持续妊娠率。
两组在总促性腺激素用量、OSI 和总获卵数及成熟卵数方面无显著差异。A 组的 A 级胚胎和受精率显著增加。着床率和妊娠率无统计学显著变化。
在开始 ICSI 周期前一个月开始用肌醇治疗直至排卵诱发，可以提高受精率和胚胎质量，并可能提高不良反应者的累积妊娠率。
