title: Myo-inositol is a promising treatment for the prevention of ovarian hyperstimulation syndrome (OHSS): an animal study.
abstract: OBJECTIVE
  To evaluate the efficacy of myo-inositol (MI) pretreatment in OHSS.
  
  
  METHODS
  In this experimental OHSS rat model, 42 immature Wistar albino female rats were divided into 6 groups: (1) the control group, (2) the ovarian stimulation group, (3) the OHSS group, (4) the OHSS + Metformin group, (5) OHSS + MI group, (6) OHSS + Metformin + MI group. OHSS was established after treatment with metformin and myo-inositol for 14 days, in the meanwhile the treatment of metformin and myo-inositol was also continued. All animals were killed 48 h after hCG administration and were compared in terms of vascular permeability, ovarian weight and diameter, ovarian VEGF, COX-2 and PEDF expression (immunohistochemistry), serum PEDF and estradiol (E2) levels.
  
  
  RESULTS
  Vascular permeability, VEGF and COX-2 expressions were reduced in animals treated with MI and/or metformin. While PEDF expression was increased in the groups taking metformin, there was no difference in PEDF expression in the group taking MI and OHSS group. There was no significant difference in serum PEDF levels between groups. Blood E2 levels were decreased in groups treated with MI or metformin compared to the OHSS group.
  
  
  CONCLUSIONS
  Our data demonstrate that myo-inositol is effective in preventing OHSS, similar to metformin. Although the two drugs are thought to act through distinct mechanisms, there is no apparent benefit to co-treatment with both drugs in an animal model of OHSS. Administration of myo-inositol prior to IVF treatment may favor the control of ovulation induction. Further studies are necessary to elucidate the mechanism of action and further support our findings.
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey. arzuturan74@yahoo.com.
authors.forename: Guluzar Arzu
authors.initials: GA
authors.lastname: Turan
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Celal Bayar University, 45030, Manisa, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Eskicioglu
authors.affiliation: Department of Pathology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey.
authors.forename: Oya Nermin
authors.initials: ON
authors.lastname: Sivrikoz
authors.affiliation: Biostatistics and Medical Informatics, Medical School, Sifa University, Ankara Cad. No:45, 35100, Bayrakli, Izmir, Turkey.|Molecular Medicine, Institute of Health Science, Dokuz Eylül University, Mithatpasa cad. No:1606 inciraltı yerleskesi, 35340, Balcova, Izmir, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Cengiz
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey.
authors.forename: Saban
authors.initials: S
authors.lastname: Adakan
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey.
authors.forename: Esra Bahar
authors.initials: EB
authors.lastname: Gur
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey.
authors.forename: Sumeyra
authors.initials: S
authors.lastname: Tatar
authors.affiliation: Department of Obstetrics and Gynecology, Medical School, Sifa University, Sanayi cad no:7, 35100, Bornova, Izmir, Turkey.
authors.forename: Nur
authors.initials: N
authors.lastname: Sahin
authors.affiliation: Department of Laboratory Animal Science, Medical School, Dokuz Eylul University, Mithatpasa cad. No:1606 inciraltı yerleskesi, 35340, Balcova, Izmir, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Yilmaz
mesh_terms: D000818:Animals; D051545:Cyclooxygenase 1 / Q000378:metabolism; D004195:Disease Models, Animal; D004958:Estradiol / Q000627:therapeutic use; D005260:Female; D007294:Inositol / Q000627:therapeutic use*; D008565:Membrane Proteins / Q000378:metabolism; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control*; D010062:Ovulation Induction; D051381:Rats; D017208:Rats, Wistar; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014803:Vitamin B Complex / Q000627:therapeutic use*
chemical_list: D008565:Membrane Proteins; D042461:Vascular Endothelial Growth Factor A; D014803:Vitamin B Complex; D007294:Inositol; D004958:Estradiol; D051545:Cyclooxygenase 1; C496513:Ptgs1 protein, rat
keywords: Metformin; Myo-inositol; Ovarian hyperstimulation syndrome; Pigment epithelium-derived factor; Vascular endothelial growth factor