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. 2025 Mar 15;15(1):20.
doi: 10.1186/s13561-025-00609-8.

A retrospective study "myo-inositol is a cost-saving strategy for controlled ovarian stimulation in non-polycystic ovary syndrome art patients."

Cesare Aragona  1   2 , Michele Russo  3 , Samuel H Myers  3 , Maria Salomé Bezerra Espinola  1   2 , Gabriele Bilotta  4 , Vittorio Unfer  5   6
Affiliations

A retrospective study "myo-inositol is a cost-saving strategy for controlled ovarian stimulation in non-polycystic ovary syndrome art patients."

Cesare Aragona et al. Health Econ Rev. .

Abstract

Background: Fertility care represents a financial burden on patients and healthcare services alike and can represent a barrier to entry for many couples. Controlled ovarian stimulation (COH) is routinely used as part of in vitro fertilization and intracytoplasmic sperm injection (ICSI) procedures, as such the use of gonadotropins is a major contributing factor to the cost of the procedure. Recent studies have shown that myo-Inositol (myo-ins) may reduce the amount of gonadotrophins required in assisted reproductive technology (ART) procedures. This retrospective study measured the effect of myo-ins on the number of recombinant follicular stimulating hormone (rFSH) units used in IVF and ICSI and the relative cost to verify if this may be a cost saving strategy. We also investigated the oocyte and embryo quality, implantation rate, abortion rate, clinical pregnancy, and ovarian hyperstimulation syndrome.

Methods: A total of 300 women undergoing either IVF or ICSI were distributed between two distinct and equal patient groups of 150 women. In control group (group A), folic acid (FA) alone was prescribed, meanwhile the treated group (group B) were prescribed FA, myo-Inositol (myo-ins) and alpha-lactalbumin (α-LA), both groups started this oral treatment in the middle of the luteal phase.

Results: Myo-Ins supplementation in the treatment group significantly reduced the number of units of rFSH used in COH vs. the control group (2526 vs. 1647, p < 0.05); however, no changes were seen in other measured outcomes, likely due to the short treatment period.

Conclusions: The use of myo-Ins presents a safe method for reducing the amount and subsequent costs of rFSH usage in ART protocols.

Trial registration: The trial was retrospectively registered with the Institutional Review Board of ALMA RES IVF Center, trial number n°2/2024.

Keywords: COH; ICSI; IVF; OHSS; PCOS; Pharmacoeconomics; myo-Inositol.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: Ethical approval was granted from the Alma Res Fertility Center in Rome (Italy). The approval of study was recorded as n°2/2024 by the Institutional Review Board of ALMA RES IVF Center and conducted according to the ethical principles of the Declaration of Helsinki. Written consent was obtained from all participants. Competing interests: M.R, S.H.M, and V.U are employees of Lo.Li. pharma s.r.l. All other authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of the study. Summary of the design and main steps followed in the study. Myo-Ins: myo-Inositol, α-La: α-Lactalbumin, COH: controlled ovarian hyperstimulation
Fig. 2
Fig. 2
Summary of cost saving in COH cycles. Schematic representation of the cost saving calculated between the study and the control group. Given a fixed price for a single unit of gonadotropin charged to the Italian Health System, by multiplying this cost for the mean values of the gonadotropin used in each group we observe a relative difference representing a cost saving when myo-Ins is used before COH procedure
See this image and copyright information in PMC

References

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