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多囊卵巢综合征患者服用肌醇后血清和卵泡液生化指标及卵胞浆内单精子注射结局的改善:前瞻性随机研究

Improvement in biochemical manifestations of the serum and follicular fluid and ICSI outcomes in PCOS patients with myo-inositol administration: prospective randomized research.

作者信息

Yazdanpanah Zeynab, Cheraghi Ebrahim, Nasrabadi Mitra Heydari, Salehipour Masoud

机构信息

Department of Biology, Parand Branch, Islamic Azad University, Bahonar Blvd, Tehran, Iran.

Department of Biology, Faculty of Sciences, University of Qom, Qom, Iran.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2025 Jun;398(6):7187-7198. doi: 10.1007/s00210-024-03745-w. Epub 2024 Dec 24.

Abstract

The research investigated the capacity of myo-inositol (MI) in order that it improves biochemical markers in serum and follicular fluid and, ultimately, intracytoplasmic sperm injection (ICSI) outcomes of women with PCOS. Sixty infertile patients with PCOS, who were undergoing ovulation induction for ICSI, were randomly divided to two groups. The MI group received 2000 mg myo-inositol + 1 mg folic acid twice a day for 6 weeks with starting the ICSI cycle. For the same period, the control group received a placebo containing only folic acid (1 mg). Levels of hormonal profiles in serum and follicular fluid, as well as oxidative stress markers (MDA, TAC, GPx, and SOD), were estimated using an ELISA assay. Primary end points were ICSI cycle outcomes. Compared to the placebo group, the MI group demonstrated significant reduction in serum and follicular fluid levels of LH, LH/FSH ratio, total testosterone, AMH, and androstenedione. Furthermore, the MI group exhibited meaningful increases in TAC, GPx, and SOD, but MDA significantly decreased. While the number of retrieved and mature oocytes is not statistically similar among the groups, the MI group showed significant improvements in the percentage of immature oocytes, cleavage rate, and good embryo quality. A meaningful correlation was checked between follicular fluid AMH level and LH, FSH, total testosterone, androstenedione, insulin, MDA, the number of retrieved oocytes, and immature oocytes. Our outcomes indicate that myo-inositol administration in women with PCOS undergoing ART helps to improve their hormonal profiles, and the quality of oocytes and embryos. Registration details: Date: 2022.10.19, Registry: https://irct.behdasht.gov.ir/trial/66005 , and Trial registration: IRCT202220921056008N1.

摘要

该研究调查了肌醇(MI)改善血清和卵泡液中生化标志物的能力,以及最终对多囊卵巢综合征(PCOS)女性的卵胞浆内单精子注射(ICSI)结局的影响。60例接受ICSI排卵诱导的PCOS不孕患者被随机分为两组。MI组在开始ICSI周期时,每天两次服用2000毫克肌醇+1毫克叶酸,持续6周。同期,对照组接受仅含叶酸(1毫克)的安慰剂。使用酶联免疫吸附测定法评估血清和卵泡液中的激素水平以及氧化应激标志物(丙二醛、总抗氧化能力、谷胱甘肽过氧化物酶和超氧化物歧化酶)。主要终点是ICSI周期结局。与安慰剂组相比,MI组血清和卵泡液中的促黄体生成素(LH)、LH/促卵泡生成素(FSH)比值、总睾酮、抗苗勒管激素(AMH)和雄烯二酮水平显著降低。此外,MI组的总抗氧化能力、谷胱甘肽过氧化物酶和超氧化物歧化酶显著升高,但丙二醛显著降低。虽然各组间回收和成熟卵母细胞的数量在统计学上无差异,但MI组在未成熟卵母细胞百分比、卵裂率和优质胚胎质量方面有显著改善。对卵泡液AMH水平与LH、FSH、总睾酮、雄烯二酮、胰岛素、丙二醛、回收卵母细胞数量和未成熟卵母细胞数量之间进行了有意义的相关性检验。我们的结果表明,接受辅助生殖技术(ART)的PCOS女性服用肌醇有助于改善其激素水平以及卵母细胞和胚胎的质量。注册详情:日期:2022年10月19日,注册机构:https://irct.behdasht.gov.ir/trial/66005 ,试验注册号:IRCT202220921056008N1。

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