Prospective randomized trial of multiple micronutrients in subfertile women undergoing ovulation induction: a pilot study

Agrawal, Rina; Burt, Elizabeth; Gallagher, Anne Marie; Butler, Lisa M.; Venkatakrishnan, Radha; Peitsidis, Panagiotis

doi:10.1016/j.rbmo.2011.10.004

Cited by 28 publications

(16 citation statements)

References 37 publications

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“…One pilot study found Pregnancycare was associated with higher pregnancy rates in subfertile/infertile women undergoing ovulatory induction [20] but none of the Pregnancycare reviewers on Amazon reported using Clomid or other ovulatory induction treatments. Another low-power study reports higher pregnancy rates among 53 FertiliBlend users who had previously tried to conceive for 6-36 months [21] but, in the absence of follow-up studies with greater power, it is difficult to ascertain if this difference between treatment groups was clinically meaningful.…”

Section: Methodsmentioning

confidence: 99%

How Feedback Biases Give Ineffective Medical Treatments a Good Reputation

Barra¹,

Eriksson²,

Strimling³

2014

J Med Internet Res

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BackgroundMedical treatments with no direct effect (like homeopathy) or that cause harm (like bloodletting) are common across cultures and throughout history. How do such treatments spread and persist? Most medical treatments result in a range of outcomes: some people improve while others deteriorate. If the people who improve are more inclined to tell others about their experiences than the people who deteriorate, ineffective or even harmful treatments can maintain a good reputation.ObjectiveThe intent of this study was to test the hypothesis that positive outcomes are overrepresented in online medical product reviews, to examine if this reputational distortion is large enough to bias people’s decisions, and to explore the implications of this bias for the cultural evolution of medical treatments.MethodsWe compared outcomes of weight loss treatments and fertility treatments in clinical trials to outcomes reported in 1901 reviews on Amazon. Then, in a series of experiments, we evaluated people’s choice of weight loss diet after reading different reviews. Finally, a mathematical model was used to examine if this bias could result in less effective treatments having a better reputation than more effective treatments.ResultsData are consistent with the hypothesis that people with better outcomes are more inclined to write reviews. After 6 months on the diet, 93% (64/69) of online reviewers reported a weight loss of 10 kg or more while just 27% (19/71) of clinical trial participants experienced this level of weight change. A similar positive distortion was found in fertility treatment reviews. In a series of experiments, we show that people are more inclined to begin a diet with many positive reviews, than a diet with reviews that are representative of the diet’s true effect. A mathematical model of medical cultural evolution shows that the size of the positive distortion critically depends on the shape of the outcome distribution.ConclusionsOnline reviews overestimate the benefits of medical treatments, probably because people with negative outcomes are less inclined to tell others about their experiences. This bias can enable ineffective medical treatments to maintain a good reputation.

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Section: Methodsmentioning

confidence: 99%

How Feedback Biases Give Ineffective Medical Treatments a Good Reputation

Barra¹,

Eriksson²,

Strimling³

2014

J Med Internet Res

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“…This molecule, as demonstrated by some studies [14, 15], seems to be able to work in synergy in all forms of PCOS, both in those induced by insulin resistance and in cases of tissue oxidative stress.…”

Section: Discussionmentioning

confidence: 85%

The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP) in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance

Sacchinelli

Venturella

Lico

et al. 2014

Obstetrics and Gynecology International

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Objective. Substances such as inositol and N-acetylcysteine (NAC) have been recently shown to be effective in treatment of PCOS patients. The aim of this prospective trial is to evaluate the efficacy of NAC + Inositol + folic acid on ovulation rate and menstrual regularity in PCOS patients with and without insulin resistance. Methods. Among the 91 PCOS patients treated with NAC + Inositol + folic, insulin resistance was present in 44 subjects (A) and absent in 47 (B). The primary endpoint was the ovulation rate/year, determined by menstrual diary, serum progesterone performed between 21° and 24° days, ultrasound findings of growth follicular or luteal cysts, and luteal ratio. HOMA-index assessment after 6 and 12 months of treatment was evaluated as secondary endpoint. Results. In both groups there was a significant increase in ovulation rate and no significant differences were found in the primary outcome between two groups. In group A, a significant reduction of HOMA-index was observed. Conclusions. The association NAC + Inositol + folic, regardless of insulin-resistance state, seems to improve ovarian function in PCOS patients. Therefore, inositol and NAC may have additional noninsulin-related mechanisms of action that allow achieving benefits also in those patients with negative HOMA-index.

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“…To determine whether there is a superior treatment regimen for infertile patients, several studies have been conducted to compare the efficacy of different kinds of antioxidants in the past few years [29], but little attention has been given to female infertility [24] and none have addressed PCOS. One prospective randomized trial investigated whether a subordinate multiple micronutrient (MMN) supplementation providing folic acid, vitamin B, vitamin E, vitamin C, zinc, selenium, vitamin A and other multivitamins/minerals could benefit women with anovulatory infertility or unexplained infertility who were undergoing ovulation induction by the standard treatment regimen with CC and HMG [30]. It was observed that women on MMN supplementation had a significantly higher cumulative clinical pregnancy rate and ongoing pregnancy rate compared with those who were on folic acid alone.…”

Section: Discussionmentioning

confidence: 99%

Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study

et al. 2020

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Background: Vitamin E, which is critically important in the whole process of reproduction, can antagonize the oxidative stress caused by the oxygen free radicals and antioxidant imbalance and regulate normal physiological function of the reproductive system. The effect of short-term supplementation of vitamin E on outcomes of infertile women with polycystic ovary syndrome (PCOS) when they underwent ovulation induction with clomiphene citrate (CC) and human menopausal gonadotropin (HMG) remains unknown. Methods: This was a retrospective cohort clinical trial from October 2015 to April 2017. A total of 321 PCOS cases underwent ovulation induction with CC and HMG. Patients in group A (n = 110) did not receive vitamin E while patients in group B (n = 105) and group C (n = 106) received oral treatment of vitamin E at 100 mg/day during follicular phase and luteal phase, respectively.Results: It was observed no significant differences of ovulation rate, clinical pregnancy rate, and ongoing pregnancy rate among the three groups. It was interesting that dosage of HMG were significant lower in group B compared with those in group A and group C (P<0.05). Conclusions:A short-term supplementation of vitamin E can improve oxidative stress, and reduce exogenous HMG dosage to lower the economic cost with a similar pregnancy rate in the ovulation induction cycle. However, the supplementation does not alter the pregnancy rate in the ovulation induction cycle.

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Prospective randomized trial of multiple micronutrients in subfertile women undergoing ovulation induction: a pilot study

Cited by 28 publications

References 37 publications

How Feedback Biases Give Ineffective Medical Treatments a Good Reputation

How Feedback Biases Give Ineffective Medical Treatments a Good Reputation

The Efficacy of Inositol and N-Acetyl Cysteine Administration (Ovaric HP) in Improving the Ovarian Function in Infertile Women with PCOS with or without Insulin Resistance

Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study

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