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Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is often characterized by chronic oligo- or anovulation (usually manifested as oligo- or amenorrhea), and hyperandrogenism. In addition, 30-40% of PCOS women have impaired glucose tolerance, and a defect in the insulin signaling pathway (inositol-containing phosphoglycan mediators) seems to be implicated in the pathogenesis of insulin resistance. PCOS patients are subfertile as a consequence of such ovulatory disorders and often need drugs, such as clomiphene citrate or follicle-stimulating hormone, for ovulation induction, which increases the risk of multiple pregnancy and ovarian hyperstimulation syndrome. We hypothesized that the administration of an isoform of inositol (myo-inositol), belonging to the vitamin B complex, would improve the insulin-receptor activity, restoring normal ovulatory function.

MATERIALS AND METHODS

Twenty-five PCOS women of childbearing age with oligo- or amenorrhea were enrolled in the study. Ovulatory disorder due to PCOS was apparently the only cause of infertility; no tubal defect or deficiency of male semen parameters was found. Myo-inositol combined with folic acid (Inofolic) 2 g twice a day was administered continuously. During an observation period of 6 months, ovulatory activity was monitored with ultrasound scan and hormonal profile, and the numbers of spontaneous menstrual cycles and eventually pregnancies were assessed.

RESULTS

Twenty-two out of the 25 (88%) patients restored at least one spontaneous menstrual cycle during treatment, of whom 18 (72%) maintained normal ovulatory activity during the follow-up period. A total of 10 singleton pregnancies (40% of patients) were obtained. Nine clinical pregnancies were assessed with fetal heart beat at ultrasound scan. Two pregnancies evolved in spontaneous abortion.

CONCLUSION

Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS. This therapy did not cause multiple pregnancy.

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  • Authors+Show Affiliations

    ,

    IVF Unit, Gynaecological-Obstetric Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy. papaleo.enrico@hsr.it

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    Source

    MeSH

    Adult
    Drug Therapy, Combination
    Female
    Folic Acid
    Humans
    Infertility, Female
    Inositol
    Live Birth
    Ovulation Induction
    Polycystic Ovary Syndrome
    Pregnancy
    Pregnancy Outcome
    Vitamin B Complex

    Pub Type(s)

    Clinical Trial
    Journal Article

    Language

    eng

    PubMed ID

    17952759

    Citation

    Papaleo, Enrico, et al. "Myo-inositol in Patients With Polycystic Ovary Syndrome: a Novel Method for Ovulation Induction." Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, vol. 23, no. 12, 2007, pp. 700-3.
    Papaleo E, Unfer V, Baillargeon JP, et al. Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecol Endocrinol. 2007;23(12):700-3.
    Papaleo, E., Unfer, V., Baillargeon, J. P., De Santis, L., Fusi, F., Brigante, C., ... Ferrari, A. (2007). Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology, 23(12), pp. 700-3.
    Papaleo E, et al. Myo-inositol in Patients With Polycystic Ovary Syndrome: a Novel Method for Ovulation Induction. Gynecol Endocrinol. 2007;23(12):700-3. PubMed PMID: 17952759.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Myo-inositol in patients with polycystic ovary syndrome: a novel method for ovulation induction. AU - Papaleo,Enrico, AU - Unfer,Vittorio, AU - Baillargeon,Jean-Patrice, AU - De Santis,Lucia, AU - Fusi,Francesco, AU - Brigante,Claudio, AU - Marelli,Guido, AU - Cino,Ilaria, AU - Redaelli,Anna, AU - Ferrari,Augusto, Y1 - 2007/10/10/ PY - 2007/10/24/pubmed PY - 2008/3/12/medline PY - 2007/10/24/entrez SP - 700 EP - 3 JF - Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology JO - Gynecol. Endocrinol. VL - 23 IS - 12 N2 - BACKGROUND: Polycystic ovary syndrome (PCOS) is often characterized by chronic oligo- or anovulation (usually manifested as oligo- or amenorrhea), and hyperandrogenism. In addition, 30-40% of PCOS women have impaired glucose tolerance, and a defect in the insulin signaling pathway (inositol-containing phosphoglycan mediators) seems to be implicated in the pathogenesis of insulin resistance. PCOS patients are subfertile as a consequence of such ovulatory disorders and often need drugs, such as clomiphene citrate or follicle-stimulating hormone, for ovulation induction, which increases the risk of multiple pregnancy and ovarian hyperstimulation syndrome. We hypothesized that the administration of an isoform of inositol (myo-inositol), belonging to the vitamin B complex, would improve the insulin-receptor activity, restoring normal ovulatory function. MATERIALS AND METHODS: Twenty-five PCOS women of childbearing age with oligo- or amenorrhea were enrolled in the study. Ovulatory disorder due to PCOS was apparently the only cause of infertility; no tubal defect or deficiency of male semen parameters was found. Myo-inositol combined with folic acid (Inofolic) 2 g twice a day was administered continuously. During an observation period of 6 months, ovulatory activity was monitored with ultrasound scan and hormonal profile, and the numbers of spontaneous menstrual cycles and eventually pregnancies were assessed. RESULTS: Twenty-two out of the 25 (88%) patients restored at least one spontaneous menstrual cycle during treatment, of whom 18 (72%) maintained normal ovulatory activity during the follow-up period. A total of 10 singleton pregnancies (40% of patients) were obtained. Nine clinical pregnancies were assessed with fetal heart beat at ultrasound scan. Two pregnancies evolved in spontaneous abortion. CONCLUSION: Myo-inositol is a simple and safe treatment that is capable of restoring spontaneous ovarian activity and consequently fertility in most patients with PCOS. This therapy did not cause multiple pregnancy. SN - 0951-3590 UR - https://www.unboundmedicine.com/medline/citation/17952759/Myo_inositol_in_patients_with_polycystic_ovary_syndrome:_a_novel_method_for_ovulation_induction_ L2 - http://www.tandfonline.com/doi/full/10.1080/09513590701672405 DB - PRIME DP - Unbound Medicine ER -