Improvement in biochemical manifestations of the serum and follicular fluid and ICSI outcomes in PCOS patients with myo-inositol administration: prospective randomized research

Naunyn Schmiedebergs Arch Pharmacol. 2025 Jun;398(6):7187-7198. doi: 10.1007/s00210-024-03745-w. Epub 2024 Dec 24.

Abstract

The research investigated the capacity of myo-inositol (MI) in order that it improves biochemical markers in serum and follicular fluid and, ultimately, intracytoplasmic sperm injection (ICSI) outcomes of women with PCOS. Sixty infertile patients with PCOS, who were undergoing ovulation induction for ICSI, were randomly divided to two groups. The MI group received 2000 mg myo-inositol + 1 mg folic acid twice a day for 6 weeks with starting the ICSI cycle. For the same period, the control group received a placebo containing only folic acid (1 mg). Levels of hormonal profiles in serum and follicular fluid, as well as oxidative stress markers (MDA, TAC, GPx, and SOD), were estimated using an ELISA assay. Primary end points were ICSI cycle outcomes. Compared to the placebo group, the MI group demonstrated significant reduction in serum and follicular fluid levels of LH, LH/FSH ratio, total testosterone, AMH, and androstenedione. Furthermore, the MI group exhibited meaningful increases in TAC, GPx, and SOD, but MDA significantly decreased. While the number of retrieved and mature oocytes is not statistically similar among the groups, the MI group showed significant improvements in the percentage of immature oocytes, cleavage rate, and good embryo quality. A meaningful correlation was checked between follicular fluid AMH level and LH, FSH, total testosterone, androstenedione, insulin, MDA, the number of retrieved oocytes, and immature oocytes. Our outcomes indicate that myo-inositol administration in women with PCOS undergoing ART helps to improve their hormonal profiles, and the quality of oocytes and embryos. Registration details: Date: 2022.10.19, Registry: https://irct.behdasht.gov.ir/trial/66005 , and Trial registration: IRCT202220921056008N1.

Keywords: Intracytoplasmic sperm injection; Myo-inositol; Polycystic ovarian syndrome; Reproductive outcomes.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biomarkers / metabolism
  • Female
  • Folic Acid / administration & dosage
  • Folic Acid / therapeutic use
  • Follicular Fluid* / drug effects
  • Follicular Fluid* / metabolism
  • Humans
  • Infertility, Female* / blood
  • Infertility, Female* / etiology
  • Infertility, Female* / therapy
  • Inositol* / administration & dosage
  • Inositol* / pharmacology
  • Inositol* / therapeutic use
  • Ovulation Induction / methods
  • Oxidative Stress / drug effects
  • Polycystic Ovary Syndrome* / blood
  • Polycystic Ovary Syndrome* / drug therapy
  • Polycystic Ovary Syndrome* / metabolism
  • Pregnancy
  • Prospective Studies
  • Sperm Injections, Intracytoplasmic* / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Inositol
  • Biomarkers
  • Folic Acid