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This is a prospective comparative randomized controlled study investigating the effect of Myo-Inositol-based co-treatment on oocyte quality measures in women with PCOS.
Polycystic Ovary Syndrome is the most common cause of chronic anovulation in women. Women with PCOS undergoing IVF are at an increased risk for developing both multiple gestation and ovarian hyperstimulation syndrome (OHSS). Since insulin resistance and hyperinsulinemia have been implicated in the pathophysiology of the disorder, the administration of metformin before or during an IVF cycle has been practiced for years in an attempt to improve follicular parameters necessary for reproductive success. Recently, a growing body of evidence has implicated alternative insulin sensitizing drugs, namely Myo-Inositol, in improving various manifestations of the disorder in this women population. Little has been done to evaluate the effect of Myo-Inositol co-treatment on the reproductive performance of PCOS women undergoing Assisted Reproductive Technologies (ART). In this prospective comparative randomized controlled study, women will be randomized into two groups: Women in the control group will receive folic acid daily. Women in the study group will receive Myo-Inositol, in combination with alpha- lipoic acid and cysteine, per day plus folic acid supplemented daily along with ovarian stimulation.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Myo-Inositol | Experimental | 1g Myo-inositol per day, in combination with alpha- lipoic acid and cysteine, (Celine Tablets; Surveal Pharmaceuticals; Belgium) + 400 ug of Folic acid |
|
| No intervention | No Intervention | Standard care: 400 ug of Folic acid |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Myo-inositol | Drug | Patients belonging to this group will receive 1 gram of Myo-Inositol, in combination with alpha- lipoic acid and cysteine, (Celine Tablets; Surveal Pharmaceuticals; Belgium) starting 6 weeks prior to stimulation and extending until final oocyte maturation, combined with 400 µg of folic acid supplemented daily. |
| Measure | Description | Time Frame |
|---|---|---|
| Oocyte yield | 1 day from ovum pick up | |
| Maturation rate | 1 day from ovum pick up | |
| Fertilization rate | 16-18 hours post insemination |
| Measure | Description | Time Frame |
|---|---|---|
| Blood profile (fasting sugar and insulin levels, Testosterone, Sex Hormone-Binding protein, DHEAs, and Androstenedione) | Prior to and 6 weeks post enrollment | |
| Number of gonadotropin ampules | 1 day from oocyte maturation trigger |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Johnny Awwad, MD | Contact | 009611350000 | 5606 | jawwad@aub.edu.lb |
| Layal Hamdar, MS | Contact | 009611350000 | 5606 | lh72@aub.edu.lb |
| Name | Affiliation | Role |
|---|---|---|
| Johnny Awwad, MD | American University of Beirut Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| American University of Beirut Medical Center | Recruiting | Beirut | Lebanon |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39421989 | Derived | Shukla R, Chadha M, Adya A, Yadav A, Singh N, Chauhan RS, Ahmad A, Tiwari RK. Ongoing Clinical Trials for Polycystic Ovarian Syndrome (PCOS) Afflicted Infertility in Women: A Narrative Review. Rev Recent Clin Trials. 2025;20(2):113-123. doi: 10.2174/0115748871325070241008101355. |
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| ID | Term |
|---|---|
| D007246 | Infertility |
| D011085 | Polycystic Ovary Syndrome |
| ID | Term |
|---|---|
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D010048 | Ovarian Cysts |
| D003560 | Cysts |
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| ID | Term |
|---|---|
| D007294 | Inositol |
| ID | Term |
|---|---|
| D013402 | Sugar Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D002241 | Carbohydrates |
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|
| Obstetrical outcome (preterm birth) | From 24 to 36 weeks gestation |
| Obstetrical outcome (low birth weight) | From 24 to 36 weeks gestation |
| Obstetrical outcome (gestational diabetes) | From 24 to 36 weeks gestation |
| Obstetrical outcome (preeclampsia) | From 24 to 36 weeks gestation |
| Obstetrical outcome (admission to neonatal intensive care) | From 24 to 36 weeks gestation |
| Number of stimulation days | 1 day from oocyte maturation trigger |
| Embryo quality | 3 to 5 days from ovum pick up |
| Miscarriage rate | 7 weeks post LMP |
| Ongoing pregnancy | 20 weeks post LMP |
| Live birth rate | 24 to 42 weeks gestation |
| D009369 |
| Neoplasms |
| D010049 | Ovarian Diseases |
| D000291 | Adnexal Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D006058 | Gonadal Disorders |
| D004700 | Endocrine System Diseases |