The menstrual cycle regularization following d-chiro-inositol treatment in PCOS women: a retrospective study

Abstract

Polycystic ovary syndrome is characterized by irregular cycles, hyperandrogenism, polycystic ovary at ultrasound and insulin resistance. The effectiveness of d-chiro-inositol (DCI) treatment in improving insulin resistance in PCOS patients has been confirmed in several reports. The objective of this study was to retrospectively analyze the effect of DCI on menstrual cycle regularity in PCOS women. This was a retrospective study of patients with irregular cycles who were treated with DCI. Of all PCOS women admitted to our centre, 47 were treated with DCI and had complete medical charts. The percentage of women reporting regular menstrual cycles significantly increased with increasing duration of DCI treatment (24% and 51.6% at a mean of 6 and 15 months of treatment, respectively). Serum AMH levels and indexes of insulin resistance significantly decreased during the treatment. Low AMH levels, high HOMA index, and the presence of oligomenorrhea at the first visit were the independent predictors of obtaining regular menstrual cycle with DCI. In conclusion, the use of DCI is associated to clinical benefits for many women affected by PCOS including the improvement in insulin resistance and menstrual cycle regularity. Responders to the treatment may be identified on the basis of menstrual irregularity and hormonal or metabolic markers.

Chinese abstract

本研究目的在于评估在控制性卵巢超刺激（COH）阶段每日给予超大剂量促性腺素（450 IU/天）对患者体外受精-胚胎移植（IVF-ET）结果的影响。此外，对于给予促性腺素每日剂量450 IU治疗失败的患者，我们将剂量增至600 IU，评估她们IVF的结局。研究对象为本IVF中心接受COH治疗且每日应用促性腺素剂量为450 IU的患者。评估指标包括卵巢刺激特征、获卵数、胚胎移植数及妊娠率。本研究共纳入了901例连贯的IVF治疗周期。COH阶段无组间差异，治疗成功的患者显著特征为年龄小、获卵数目与胚胎移植数目多且无效胚胎少。进一步研究仅包含应用促性腺素450 IU每日治疗失败，且愿意尝试在接下来的治疗周期中增加促性腺素剂量至600 IU每日的患者，但结果显示增加剂量并未改善COH特征与无效胚胎率。结果表明，卵巢反应性低下的患者在接受每日超大剂量促性腺素（450 IU）COH治疗时，最重要的影响IVF成功的因素是患者年龄与获卵数目。此外，若每日促性腺素剂量为450 IU治疗失败的患者，增加剂量至600 IU并不能使其获益，建议考虑卵子捐赠或领养途径。

• AMH
• d-chiro-inositol
• insulin resistance
• PCOS

Declaration of interest

The authors declare that they have no competing interests.

Supplementary material available online

Supplementary Table S1.