Myo-Inositol’s Role in Assisted Reproductive Technology: Evidence for Improving the Quality of Oocytes and Embryos in Patients With Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common causes of subfertility, and it is characterized by hormonal dysregulation like insulin resistance. Various measures have been taken in the past to overcome this insulin resistance to improve fertility treatment outcomes. The current paper aims to review and compare the existing studies and literature to assess the impact of myo-inositol (MI) on oocyte and embryo quality in assisted reproductive technology (ARTs). We thoroughly searched the PubMed and Google Scholar databases by using the keywords "PCOS, polycystic ovarian syndrome, inositol, oocyte quality, embryo quality, assisted conception, ART, IVF, and in vitro fertilization." Nine articles were finalized for review in this paper. Many of the reviewed studies have shown a trend toward the improvement of embryo quality in women with PCOS after MI supplementation; however, there is a lack of statistically significant evidence to support the use of MI in enhancing the quality of oocyte and/or embryo. Clear evidence regarding the role of MI in enhancing the quality of oocyte and embryo in PCOS is limited. A well-controlled, large, randomized controlled trial is required to definitively accept or refute its role.

PCOS and Assisted Reproduction Technique: Role and Relevance of Inositols

“…Although most of the results are strongly encouraging towards the use of MYO and its advantages within IVF in PCOS patients, the authors ultimately conclude that to make a final definitive judgment about it, a large multicentric RCT is required [58].…”

“…Like them, other authors also focused on the effect of inositol on embryos and oocytes. Gupta et al [58] previously published a review in which they analyzed nine studies from 2009 to 2018, to investigate the role of MYO supplementation and its possible correlation with the quality of oocytes/embryos. They analyzed the number of metaphase II oocytes and the number of morphologically grade-one embryos to evaluate the aforementioned outcomes.…”

“…However, the studies analyzed showed non-homogeneous or conflicting results. Regidor et al, for example, demonstrated how MYO determined an increase in the number of metaphase II oocytes retrieved and in the number of grade I embryos, but it was not statistically significant [58,59].…”

New about the pathogenesis and treatment of polycystic ovary syndrome

“…По мнению B. Banaszewska et al [39], убедительные доказательства эффективности инозитола у пациенток с СПКЯ еще не получены. Тем не менее в течение последних лет в литературе стали накапливаться данные об эффективности обеих форм инозитолов при СПКЯ [40][41][42][43][44][45][46][47][48][49][50].…”

“…Кроме того, MI представляет собой безопасную и экономичную альтернативу в лечении СПКЯ, при этом при назначении стандартной дозировки побочных эффектов не наблюдалось. Эффективность MI в улучшении качества ооцитов и эмбрионов также показана в работе [47].…”