Effect of the treatment with myo-inositol plus folic acid plus melatonin in comparison with a treatment with myo-inositol plus folic acid on oocyte quality and pregnancy outcome in IVF cycles. A prospective, clinical trial
P. RIZZO, E. RAFFONE, V. BENEDETTO
Department of Obstetrics and Gynecology, University of Messina, Messina (Italy)
Abstract. – Objective: The aim of the study was to evaluate the efficacy of a treatmentwith myo-inositol plus folic acid plus melaton in compared with myo-inositol plus folic acid aloneon oocyte quality in women underwent in vitrofertilization (IVF) cycles.Design: A prospective, clinical trial.Materials and Methods: Starting on the day ofGnRH administration, 65 women undergoing IVFcycles were randomized in two groups to receivemyo-inositol plus folic acid plus melatonin (32women, group A), and myo-inositol plus folic acid(33 women, group B), administered continuously.Primary endpoints were number of morphologically mature oocytes retrieved (MII oocytes),embryo quality, and pregnancy rate. Secondary end points were the total number of oocytes retrieved(immature and mature oocytes), fertilizationrate per number of retrieved oocytes and embryo cleavage rate.Results: The mean number of oocytes retrieved did not differ between the two groups(7.88 ± 1.76 vs 7.67 ± 1.88; P=0.65). Whereas the group cotreated with melaton in reported a significant lygreater mean number of matureoocytes (6.56 ± 1.64 vs 5.76 ± 1.56; P=0.047) and a lower mean number of immature oocytes (1.31± 0.74 vs. 1.91 ± 0.68; P=0.001). The mean number of embyos of top-quality (class 1 and 2) resulted higher in the group A (1.69 ± 0.64 vs 1.24± 0.75; P=0.01). Fertilization rate did not differ between the two groups. A total of 22 pregnancies were obtained (13 in group A and 9 in group B;P=0.26). Clinical pregnancy rate and implantationrate were in tendency higher in the group cotreated with melatonin, although the differences did not reach statistical significance. Biochemicalpregnancy rate and abortion rate were similar in both groups.Conclusion: melaton in ameliorates the activity of myo-inositol and folic acid by improving oocyte quality and pregnancy outcome in women with low oocyte quality history.