title: Improving fertilization rate in ICSI cycles by adding myoinositol to the semen preparation procedures: a prospective, bicentric, randomized trial on sibling oocytes.
abstract: OBJECTIVE
  To evaluate whether the in vitro incubation of spermatozoa with myoinositol may improve the fertilization rate in ICSI cycles.
  
  
  METHODS
  This is a prospective, bicentric, randomized study on 500 MII sibling oocytes injected in 78 ICSI cycles performed between March and October 2013. Randomization of the oocytes into two groups was performed at the time of the denudation. Fertilization rates (per oocyte injected with spermatozoa treated with myoinositol versus per oocyte injected with spermatozoa treated with placebo) were measured as primary outcome and embryo morphology as secondary outcome. Clinical outcomes were also documented.
  
  
  RESULTS
  Fertilization rate (78.9 ± 28.6% vs 63.2 ± 36.7, P = 0.002) and percentage of grade A embryos on day 3 (59.8 ± 35.6% vs 43.5 ± 41.5, P = 0.019) were significantly higher when spermatozoa were treated in vitro with myoinositol versus placebo. No differences were found for the expanded blastocyst formation rate.
  
  
  CONCLUSIONS
  In vitro treatment of spermatozoa with myoinositol may optimize ICSI outcomes by improving the fertilization rate and embryo quality on day 3. The improvement of the number and the quality of embryos available in an ICSI cycle may have clinical utility if these findings can be confirmed.
authors.affiliation: Tecnolab-Casa di Cura La Madonnina, 20122, Milano, Italy, patriziarubino@gmail.com.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Rubino
authors.forename: Simone
authors.initials: S
authors.lastname: Palini
authors.forename: Sara
authors.initials: S
authors.lastname: Chigioni
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Carlomagno
authors.forename: Antonella
authors.initials: A
authors.lastname: Quagliariello
authors.forename: Silvia
authors.initials: S
authors.lastname: De Stefani
authors.forename: Andrea
authors.initials: A
authors.lastname: Baglioni
authors.forename: Carlo
authors.initials: C
authors.lastname: Bulletti
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005306:Fertilization / Q000187:drug effects; D005307:Fertilization in Vitro; D006801:Humans; D007248:Infertility, Male / Q000188:drug therapy; D007294:Inositol / Q000008:administration & dosage*; D008297:Male; D009865:Oocytes / Q000166:cytology; D011247:Pregnancy; D018873:Pregnancy Rate; D012661:Semen / Q000187:drug effects*; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa
chemical_list: D007294:Inositol