SUPPLEMETATION WITH A 3.6:1 MYO-INOSITOL TO D-CHIRO-INOSITOL RATIO FOR PATIENTS WITH PCOS TO IMPROVE OOCYTE QUALITY DURING OVARIAN STIMULATION

Problem statement

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder, in which 80% of patients have insulin resistance and compensatory hyperinsulinemia: causing hyperandrogenism and anovulation. Due to this condition oocyte quality decreases, and therefore PCOS patients are treated with insulin‐sensitizing agents. A 3.6:1 Myo-Inositol: D-chiro-Inositol (MYO:DCI) ratio has been shown to improve insulin sensitivity, oocyte quality and pregnancy rates in women with PCOS. The objective of this study was to evaluate if patients with PCOS benefit from a 3.6:1 MYO:DCI ratio treatment before ovarian stimulation.

Methods

This was a retrospective study from 2018 to 2021 which included patients diagnosed with PCOS according to the Rotterdam criteria, who were stimulated with antagonist protocol and had a minimum of 15 oocytes retrieved via oocytes pick-up (OPU). All patients went to OPU when at least one follicle reached 18 mm. All oocytes retrieved were fertilized by ICSI. Two groups of patients were made depending on the use of 3.6:1 MYO:DCI 1 month before ovarian stimulation or not. We compared the number of oocytes retrieved, MII rates/patients, fertilization rates, pregnancy rates, and number of cycles with at least one good quality embryo, using the t-Student between groups.

Results

A total of 92 cycles were included (Group 1: 46 cycles, 2020-2021) and (Group 2: 46 cycles, 2018-2021). No significant differences were obtained in number of oocytes retrieved between groups (21.5 Group 1 vs 20.7 Group 2; p=0.56), or metaphase II oocyte rates/patients (72.06% Group 1 vs 71.23% Group 2; p=0.68). However, statistically significant differences were found when we compared the fertilization rates between groups (76.9% Group 1 vs 70.44% Group 2; p=0.007); and the number of cycles without at least one good quality blastocyst to transfer between groups (4.35% Group 1 vs 17.39% Group 2; p=0.04). The clinical pregnancy was significantly higher in supplemented group compared to control group (54.39% Group 1 vs 42.65% Group 2; p=0.0203).

Conclusions

A 3.6:1 MYO:DCI ratio-based food supplement 1 month before ovarian stimulation could improve the oocyte quality and resulted in a significant increase in pregnancy rate.