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Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study

Franco Lisi1*, Piero Carfagna1, Mario M Oliva1, Rocco Rago1, Rosella Lisi1, Roberta Poverini1, Claudio Manna2, Elena Vaquero3, Donatella Caserta4, Valeria Raparelli5, Roberto Marci6 and Massimo Moscarini4

Author Affiliations

1 Center for Reproductive Medicine Research, Clinica Villa Mafalda, Rome, Italy

2 GENESIS Center for Reproductive Medicine, Rome, Italy

3 Department of Surgery, Tor Vergata - University of Rome, Rome, Italy

4 Department of Women Health and Territorial Medicine, Sapienza - University of Rome, Sant’Andrea Hospital, Rome, Italy

5 Department of Internal Medicine and Medical Specialties, Sapienza - University of Rome, Rome, Italy

6 Department of Biomedical Sciences and Advanced Therapies, Section of Obstetrics and Gynecology, University Hospital of Ferrara, Ferrara, Italy

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Reproductive Biology and Endocrinology 2012, 10:52 doi:10.1186/1477-7827-10-52

Published: 23 July 2012

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords:
Myo-inositol; Inositol; Follicle; Stimulation; IVF; ICSI; Oocytes; Embryos