Inositol: effects on oocyte quality in patients undergoing ICSI. An open study

Abstract

Objectives: Nuclear and cytoplasmic competence of human oocyte is critical for future competence of the embryo upon which ultimately depends the outcome of an ART (Assisted Reproductive Technology) treatment. Follicular microenvironment in which the oocyte develops is crucial, and this must be taken into account particularly with the use of hormonal ovarian stimulation protocols. Inositol is an important element of the follicular environment and data support that its higher level in follicular fluid correlates with the development of a good oocyte. Aim of this study is to understand the effects of treatment with inositol on oocyte quality in a sample of patients undergoing ICSI (Intracytoplasmic Sperm Injection).

Patients and methods: Assessment of oocyte/embryo quality and pregnancy rates in 149 patients divided, according to a controlled randomized pattern, into two groups: study group 1 treated with folic acid and inositol and control group 2 treated with folic acid alone.

Results: The number of patients with excellent and good oocyte quality appears to be significantly higher in group 1 (p = 0.02), as shown, they significantly increased the number of embryos of grade A transferred in the group 1 (p = 0.02) compared to group 2, despite being completely similar averages of total embryos transferred (total mean ± SD = 2.4 ± 0.8, group 1 mean ± SD = 2.4 ± 0.8, group 2 mean ± SD = 2.4 ± 0.8). There is not any significant difference between groups 1 and 2 in the number of positivity to β-hCG and in the number of biochemical pregnancies detected although it has a tendency to increase in the first and to decrease in the second for group 1. The increase in percentage of clinical pregnancies in group 1 was statistically significant (p = 0.02), whereas there was no apparent significance in the difference between the biochemical and clinical pregnancies in the two groups despite the positive trend in the study group.

Conclusions: Relying on "inositol help" to solidify our efforts, seems to be an easy path to help to deepen the effectiveness of its use in all patients still under 40 but with prior failed attempts at ICSI or diagnosed with PCOS or as "poor responders".