Does the combination of myo-inositol improve pregnancy outcomes in obese polycystic ovary syndrome women undergoing ovarian stimulation with clomiphene citrate?
Keywords:Polycystic ovary syndrome, Ovarian stimulation, Clomiphene citrate, Myo-inositol
Aim: Recent evidence has shown that Myoinositol (MI), a nutrient belonging to vitamin B family, may improve hormone profile, and the metabolic disorders accompanying polycystic ovary syndrome (PCOS), probably through the amelioration of preexisting insulin resistance. This study aimed to compare the ovulation and pregnancy outcomes of clomiphene citrate (CC) and its combination with MI in obese PCOS women with infertility.
Methods: Data concerning 80 obese, PCOS women with infertility who had undergone ovarian induction were retrieved from the institutional digital database. Controlled ovarian stimulation (OS) was performed using CC 100 mg or CC (100mg) + MI (4 g). The primary outcome measure of this study was the difference in the ovulation and the pregnancy rates of the women receiving CC (CC group) or CC+MI (combination group) for ovarian stimulation. There were 40 patients in each group.
Results: Endometrial thickness was significantly higher in the combination group than in the CC group (8.4 (1.1) mm vs. 7.7 (1.2) mm, P=0.006) and the number of the follicles>17 mm following OS was significantly higher in the combination group compared to that of the CC group (1.6 (0.5) vs. 1.4 (0.5), P=0.036). However, the rate of ovulation following OS [37 (92%) vs. 37 (92%), P=1.000] and the rate of the pregnancy were similar in CC and combination groups [6 (15%) vs. 11 (27.5%), P=0.172, respectively].
Conclusions: Compared to ovarian stimulation with CC alone, the combination provides a beneficial effect on endometrial thickness and the number of mature follicles. However, ovulation rates are similar with the two regimens. Although not statistically significant, there was a trend towards higher rates of pregnancy on CC+MI combination compared to CC alone. Further prospective and randomized trials are required to clearly address the role of the MI in management of the PCOS women with infertility.
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