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Abstract
Polycystic ovarian syndrome (PCOS) induces anovulation in women of reproductive age, and is one of the pathological factors involved in the failure of in vitro fertilization (IVF). Indeed, PCOS women are characterized by poor quality oocytes. Therefore, a treatment for enhancing oocyte quality becomes crucial for these patients. Myo-Inositol and melatonin proved to be efficient predictors for positive IVF outcomes, correlating with high oocyte quality. We tested the synergistic effect of myo-inositol and melatonin in IVF protocols with PCOS patients in a randomized, controlled, double-blind trial. Five-hundred twenty-six PCOS women were divided into three groups: Controls (only folic acid: 400 mcg), Group A (Inofolic® plus, a daily dose of myo-inositol: 4000 mg, folic acid: 400 mcg, and melatonin: 3 mg), and Group B (Inofolic®, a daily dose of myo-inositol: 4000 mg, and folic acid: 400 mcg). The main outcome measures were oocyte and embryo quality, clinical pregnancy and implantation rates. The treatment lasted from the first day of the cycle until 14 days after embryo transfer. Myo-inositol and melatonin have shown to enhance, synergistically, oocyte and embryo quality. In consideration of the beneficial effect observed in our trial and on the bases of previous studies, we decided to integrate routinely MI and M supplementation in the IVF protocols. The same treatment should be taken carefully in consideration in all procedures of this kind.
Chinese abstract
多囊卵巢综合征（PCOS）造成育龄期女性不排卵，这是体外受精（IVF）失败的病理因素之一。的确PCOS妇女的特点是卵子质量差。因此对于这些患者提高卵子质量的治疗至关重要。肌醇和褪黑素对于IVF的成功结局是很好的预测，与高质量卵子相关。我们在随机、对照、双盲试验中，检测PCOSIVF患者应用肌醇和褪黑素的协同作用。526例PCOS患者被分为三组：对照组（单纯叶酸：400 mcg），A组（外加肌醇结合叶酸,每日剂量：肌醇：4000mg, 叶酸：400mcg，褪黑素：3mg）B组（肌醇结合叶酸，每日剂量：肌醇：4000mg, 叶酸：400mcg）。主要结果指标：卵子和胚胎质量、临床妊娠率、移植率。治疗从周期第一天到胚胎移植后14天。肌醇和褪黑素显示出能协同提高卵子和胚胎质量。考虑到我们试验中发现的有益效果和以前的有关肌醇的研究，我们决定在IVF中常规用MI和M进行补充。所有这类方案的应用需慎重考虑。