A 3.6:1 myo-inositol to D-chiro-inositol ratio and antioxidant-based food supplement before IVF improves fertility in women with PCOS: a pilot observational retrospective cohort study.

چکیده اصلی

BACKGROUND: PCOS is frequently associated with metabolic disturbances, including a high prevalence of insulin resistance and compensatory hyperinsulinemia, which can impair reproductive outcomes. Previous evidence indicates that combining myo-inositol and D-chiro-inositol in a specific 3.6:1 ratio may support ovarian physiology and reproductive performance in women with PCOS. This study aimed to evaluate whether taking a 3.6:1 MYO:DCI inositol-based supplement enriched with antioxidants for at least 1 month prior to controlled ovarian stimulation could improve IVF-ICSI outcomes. METHODS: A retrospective observational cohort study was conducted, including 92 women diagnosed with PCOS according to the Rotterdam criteria. Patients were allocated to 2 groups: those who used the MYO:DCI 3.6:1 antioxidant-containing supplement (Group 1) and those who followed conventional supplementation (Group 2). Outcomes assessed included ovarian response, fertilization rates, blastocyst development and pregnancy results. RESULTS: The number of retrieved oocytes (21.5 in Group 1 vs. 20.7 in Group 2; p = 0.56) and the metaphase II oocyte rate (72.06% in Group 1 vs. 71.23% in Group 2; p = 0.68) were comparable between both groups. Notably, Group 1 achieved higher fertilization rates (77.66% vs. 71.61%; p = 0.0314) and a lower proportion of cycles without at least one good-quality blastocyst to transfer (4.35% vs. 17.39%; p = 0.0450). In addition, both clinical and ongoing pregnancy rates were significantly improved in the supplemented group (54.39% vs. 42.65%; p = 0.0203; 45.61% vs. 36.76%; p = 0.0033). CONCLUSION: This observational pilot study suggests that a pre-treatment with 3.6:1 MYO:DCI ratio and antioxidant-based supplement taken for at least 1 month prior to ovarian stimulation may improve oocyte quality and increase pregnancy rates. These findings, while promising, require confirmation in larger prospective trials.

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