title: 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.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: IVF Unit, Gynaecological-Obstetric Department, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy. papaleo.enrico@hsr.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Papaleo
authors.forename: Vittorio
authors.initials: V
authors.lastname: Unfer
authors.forename: Jean-Patrice
authors.initials: JP
authors.lastname: Baillargeon
authors.forename: Lucia
authors.initials: L
authors.lastname: De Santis
authors.forename: Francesco
authors.initials: F
authors.lastname: Fusi
authors.forename: Claudio
authors.initials: C
authors.lastname: Brigante
authors.forename: Guido
authors.initials: G
authors.lastname: Marelli
authors.forename: Ilaria
authors.initials: I
authors.lastname: Cino
authors.forename: Anna
authors.initials: A
authors.lastname: Redaelli
authors.forename: Augusto
authors.initials: A
authors.lastname: Ferrari
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology; D007294:Inositol / Q000627:therapeutic use*; D050498:Live Birth; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D014803:Vitamin B Complex; D007294:Inositol; D005492:Folic Acid