Abstract

FOLLICULAR MYOINOSITOL IS PREDICTOR OF OOCYTE MATURATION AND BEST QUALITY EMBRYOS IN POLYCYSTIC AND NON-POLYCYSTIC PATIENT IN ICSI CYCLES

Lubna Amer Al-Anbari*, Manal Taha Al-Obaidi and Wasan Hamad Jassim

ABSTRACT

Background: Inositol are distributed in mammalian tissues and cells
where they achieve important biologic functions, which have a role in
regulating hormones activities like follicle stimulating hormone FSH,
thyroid stimulating hormone TSH and insulin as a second messenger.
Myoinositol has a positive effect on fertility and a role in reproduction
and actively imported into mammalian cells, including oocytes and pre
implantation embryos. Poly cystic ovary syndrome (PCOS) is a
common endocrine disorder and usually associated with insulin
resistance. Myoinositol used as insulin sensitizer drug in PCOS
patients with insulin resistance. Objective: To study the effect of
myoinositol in the follicular fluid of PCOS patients with insulin
resistance on the number of retrieved oocytes, oocytes maturity and number of embryos and
to find if there is any correlation between myoinositol levels in the serum and in follicular
fluid. Patients and methods: This prospective study was undertaken in the High Institute of
Infertility diagnosis and Assisted Reproductive Technologies / Al-Nahrain University /
Baghdad/Iraq, during the period from July 2016 to April 2017. A total of 58 infertile women
forty women with Polycystic ovary syndrome (twenty of them with insulin resistance (IR)
and the other twenty were non-insulin resistance (NIR)) and eighteen non PCOS women as a
control. All of them were underwent controlled ovarian hyperstimulation for intracytoplasmic
sperm injection cycle. Long agonist protocol was used as ovulation induction protocol in all
the cases. Serum and follicular myoinositol levels were measured on the day of oocyte retrieval by using Enzyme linked immune sorbent assay (ELISA) for all cases. Comparison in serum and follicular myoinositol level between the groups and their correlation to oocyte maturation and embryo quality is done to all cases. Results: There was no significant difference among the three groups (PCOS (IR), PCOS (NIR), control) in the serum and follicular myoinositol level. In all the cases there were significant positive correlation between the follicular myoinositol level and the total number of oocytes, total number of MII, number of fertilized MII, number of grade I embryos and serum myoinositol level. Serum myoinositol levels showed strong positive correlation p-value (0.044) to the number of grade I embryos, in PCOS patients with (IR), regarding other ICSI parameters as total number of retrieved oocytes, number of mature oocytes (metaphase II), number of fertilized metaphase II; there were positive correlation between these parameter and serum myoinositol levels even the correlation was statistically not significant. Conclusion: Follicular myoinositol can be assumed as a good indicator for oocytes maturity, and predictor of higher number of fertilized MII and good quality embryos in stimulated ICSI cycles in PCOS and non PCOS patient.

Keywords: IVF, myoinositol, follicular fluid, oocyte & embryo quality.