The myo-inositol effect on the oocyte quality and fertilization rate among women with polycystic ovary syndrome undergoing assisted reproductive technology cycles: a randomized clinical trial

Arch Gynecol Obstet. 2019 Jun;299(6):1701-1707. doi: 10.1007/s00404-019-05111-1. Epub 2019 Mar 27.


Purpose: The aim of the present study was to evaluate the effect of myo-Inositol administration on oocyte quality, fertilization rate and embryo quality in patients with PCOS during assisted reproductive technology (ART) cycles.

Methods: Fifty infertile PCOS patients were randomly designated in two groups. In the study group, patients received daily doses of 4 g myo-Inositol combined with 400 mg folic acid and in the control group patients received only 400 mg folic acid from 1 month before starting the antagonist cycle until the day of ovum pick up. Oocyte and embryo qualities were assessed according to European Society of Human Reproduction and Embryology (ESHRE) guidelines. The gene expression of PGK1, RGS2 and CDC42 as a factor of oocyte quality in granulosa cells was analyzed using real-time RT-PCR. Levels of total antioxidant capacity (TAC) and reactive oxygen species (ROS) were evaluated by chemiluminescence assay in follicular fluid.

Results: The percentage of metaphase II oocyte, fertilization rate and embryo quality significantly improved in the study group (p < 0.05), but the number of retrieved oocytes and follicle count were not statistically different between groups. Furthermore, the gene expression of PGK1, RGS2 and CDC42 was significantly higher in the study group (p < 0.05) but no differences were found between two groups in terms of TAC and ROS levels.

Conclusions: The present study findings suggest that myo-Inositol alters the gene expression in granulosa cells and improves oocyte and embryo quality among PCOS patients undergoing ART.

Keywords: Assisted reproductive technology; Fertilization; Oocyte; Polycystic ovary syndrome; myo-Inositol.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Double-Blind Method
  • Female
  • Fertilization in Vitro
  • Folic Acid / pharmacology
  • Folic Acid / therapeutic use*
  • Humans
  • Infertility, Female / therapy*
  • Inositol / pharmacology
  • Inositol / therapeutic use*
  • Oocytes / drug effects*
  • Oocytes / pathology
  • Polycystic Ovary Syndrome / drug therapy*
  • Polycystic Ovary Syndrome / pathology
  • Reproductive Techniques, Assisted / standards*


  • Inositol
  • Folic Acid