Myo-Inositol And Folic Acid Supplementation For The Policystic Ovary Syndrome Patients Undergoing In-Vitro Fertilization Cycles

Öz

Aim: We evaluated the effects the administration of “Myo-inositol plus Folic acid” MI-FA supplementation on ovarian reserve markers and in-vitro fertilization IVF cycle in patients with polycystic ovary syndrome PCOS patients.Material and Methods: Totally 58 PCOS women aged

Anahtar Kelimeler

• In-vitro fertilization,polycystic ovary syndrome,myo-inositol,folic acid,pregnancy rates

In Vitro Fertilizasyon Uygulanacak Polikistik Over Sendromlu Hastalar İçin Myo-İnositol Ve Folik Asit Desteği

Öz

Amaç: Myo-inositol’un IVF hastalarında serum düzeylerinden bağımsız olarak ovaryan fonksiyon ve oosit kalitesini artırdığı izlenmiştir. Biz de bu PCOS’lu IVF hastalarında myo-inositol’un hormonal ve klinik parametreler üzerine etkisini araştırmayı hedefledik.Gereç ve Yöntemler: Ocak 2013 ve Mayıs 2015 arasında üniversitemiz üreme sağlığına IVF/ICSI için başvurmuş hastalar retrospektif olarak değerlendirildi.Tüm hastalar ikinci IVF siklusundan önce en az 12 hafta myo-inozitol ve folik asid replasmanını 1gr/gün aldı ve çalışma sonucunda klinik gebelik oranları, implantasyon oranı, toplanan oosit sayısı, metafaz 2 oosit sayısı, grade A embriyo sayısı ve siklus iptal oranları değerlendirildi.Bulgular: Çalışma sonucunda MI-FA replasmanı sonrası gebelik oranları artmış olsa da istatiksel olarak anlamlı bulunmamıştır. Benzer şekilde M2 oosit sayısında azalma 14 ve 17 mm’lik folikül sayısı ve transfer edilen embriyo sayısında artış, siklus iptal oranlarında azalma izlense de istatiksel olarak anlamlı bulunmamıştır.Sonuç: Çalışmamızda ele alınan hasta sayısı az olmakla birlikte, bazı parametrelerde tedavi öncesine göre düzelme izlenmiş ancak istatiksel anlamlılık bulunmamıştır.

Anahtar Kelimeler

• İn vitro fertilizasyon,polikistik over sendromu,myo-inositol,folik asid,gebelik oranı

Kaynakça

1. The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group: Revised 2003 consensus on diagnostic criteriaand long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41–7.
2. Rienzi L, Vajta G, Ubaldi F Predictive value of oocytemorphology in hu- man IVF: a systematic review of the literature. Hum Reprod Update 2010; 17:34–45.
3. Genazzani AD, Lanzoni C, Ricchieri F, et al. Metformin administration is more effective when non-obese patients with polycysticovary syndrome show both hyperandrogenism and hyperinsulinemia.Gynecol Endocrinol 2007;23:146–52.
4. Hasegawa I, Murakawa H, Suzuki M, et al. Effect of troglitazone onendoc- rine and ovulatory performance in women with insülin resistance related polycystic ovary syndrome. Fertil Steril 1999;71:323–7.
5. Mariangela Treglia, Robert Najjar, Arturo Bevilacqua The combined the- rapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial Sandra Colazingari. Arch Gynecol Obstet (2013) 288:1405–1411.
6. Papaleo E, Unfer V, Baillargeon JP, Fusi F, Occhi F, De Santis L Myo-i- nositol may improve oocyte quality in intracytoplasmicsperm injec- tion cycles. A prospective, controlled, randomized trial. Fertil Steril 2009;91:1750–1754.
7. Carlomagno G, Unfer V, Roseff S. The D-chiro-inositol paradox in the ovary. Fertil Steril 2011;95:2515–2516.
8. Unfer V, Carlomagno G, Rizzo P, Raffone E, Roseff S. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. Aprospective, controlled, randomized trial. Eur Rev Med Pharmacol Sci 2011;15:452–457

9. Kane MT: The effects of water-soluble vitamins on the expansion ofrabbit blastocysts in vitro. J Exp Zool 1988, 245:220–223.
10. Berridge MJ: Inositol lipids and cell proliferation. Biochim Biophys Acta 1987, 907:33–45.
11. Downes CP: Twenty-fifth Colworth medal lecture. The cellular functions of myo-inositol. Biochem Soc Trans 1989, 17:259–268.
12. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome. A randomized study P. G. Artini1, O. M. Di Berardino1, F. Papini1, A. D. Genazzani2, G. Simi1, M. Ruggiero1, and V. Cela1 Gynecol Endocrinol, 2013; 29: 375–379.
13. Zacche MM, Caputo L, Filippis S, Zacche G, Dindelli M, Ferrari A. Efficacy of myo-inositol in the treatment of cutaneous disorders in young women with polycystic ovary syndrome. Gynecol Endocrinol 2009;25:508–513.
14. Gerli S, Mignosa M, Di Renzo GC. Effects of inositol on ovarian function and metabolic factors in women with PCOS: a randomized double blind placebo-controlled trial. Eur Rev Med Pharmacol Sci 2003;7:151–9.
15. Landay M.Huang A.Azziz R.Degree of hyperinsulinemia, independent of androgen levels ,is an important determinant of the severity of hirsutism in PCOS.Fertil Steril 2009;92-643-7
16. Papaleo E, Unfer V, Beillargeon JP, et al. Myoinositol in patients with pol- ycystic ovary syndrome a novel method for ovulation induction. Gynecol Endocrinol 2007;23:700–70.
17. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction inPCOS women. Gynecol Endocrinol 2010; 26:275–280.
18. Chiu TT, Rogers MS, Briton-Jones C, Haines C. Effects of myo-inositol on the in vitro maturation and subsequent developmentof mouse oocytes. Hum Reprod 2003;18:408–416
19. Lisi F, Carfagna P, Oliva MM, Rago R, Lisi R, Poverini R et al. Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergo- ing multiple follicular stimulation for IVF: a pilot study. Reprot Bio Endoc 2012, 10:52http://www.rbej.com/content/10/1/52
20. Ciotta L, Stracquadanio M, Pagano I, Carbonaro A, Palumbo M, Gulino F Effects of myo-inositol supplementation onoocyte’s quality in PCOS patients: a double blind trial. Eur Rev Med Pharmacol Sci 2011;15:509– 514
21. Goud PT, Goud AP, Oostveldt PV, Dhont M. Presence and dynamic redist- ribution of type I inositol, 1,4,5-triphosphate receptor in human oocytes and embryos during in-vitro maturation, fertilizationand early cleavage division. Mol Hum Reprod 1999;5:441–51.