Pregravid preparation of women with polycystic ovary syndrome.
DOI:
https://doi.org/10.18370/2309-4117.2020.53.30-34Keywords:
PCOS, insulin resistance, hyperandrogenia, metabolic disorders, myo-inositol, pregravid preparation.Abstract
Polycystic ovary syndrome (PCOS) is a significant component in the structure of diseases that cause female infertility, and the most common cause of ovarian dysfunction in women of reproductive age. This disease significantly increases the risk of miscarriage, the development of preterm labor, and increases the incidence of perinatal complications such as gestational diabetes, fetal macrosomia, and gestational hypertension.
A comparative prospective study was conducted with 60 patients of reproductive age suffering from PCOS (phenotype A) and having an increased body mass index. At the beginning of the study, all patients received recommendations about an individually selected reduction diet, a set of physical exercises, and adherence to an eight-hour night's sleep regimen. By random sampling, the patients were divided into 2 groups of 30 people each. For 6 months, the patients of the main group received twice a day 1 sachet Miofolik. 1 sachet contains: myo-inositol 2000 mg, vitamin B12 5 μg, folic acid ((68)-5-methyltetrahydrofolate) 200 μg. Patients in the control group did not receive drug support, observing dietary recommendations and performing a set of physical exercises only.
An analysis of the results of the study of the drug Myofolik in women with PCOS indicates its positive complex effect on metabolic disorders (improved lipid and carbohydrate metabolism), decreased hyperandrogenia, restoration of the ovulatory cycle (decreased levels of LH and LH / FSH, increased levels of estradiol, progesterone), which accordingly significantly increases the chances of pregnancy. The results of the study allow us to recommend the drug Miofolik for pregravid preparation in patients with polycystic ovary syndrome.
References
- Gromova, O.A., Torshin, I.Yu., Limanova, O.A. “Perspectives of using myo-inositol in women with polycystic ovary syndrome and insulin resistance as a part of pregravid preparation for in vitro fertilization”. Effektivnaya farmakoterapiya (2013). 5.(51).
- March, W.A., Moore, V.M., Willson, K.J., et al. “The prevalence of polycystic ovary syndrome in community sample assessed under contrasting diagnostic criteria.” Hum Reprod 25.2 (2010): 544–51.
- Kapshuk, I.M., Islamova, H.О. “Features of treatment of polycystic ovary syndrome in women with metabolic syndrome.” A word about health 13.1 (2018): 32–6.
- Kalugina, L.V., Yusko, T.I. “Myo-inositol therapeutic possibilities and pregnancy preparation for polycystic ovary syndrome (literature review).” Reproductive endocrinology 4.42 (2018): 40–45. DOI: 10.18370/2309-4117.2018.42.40-45
- Tatarchuk, T.F., Hanzhyi, I.Y., Pedachenko, N.Y, Kapshuk, I.M. “Modern possibilities of non-hormonal treatment of polycystic ovary syndrome in obese women.” Reproductive endocrinology 5.13 (2013):19–21. DOI: 10.18370/2309-4117.2013.13.14-21
- Unfer, V., Carlomagno, G., Dante, G., et al. “Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.” Gynecol Endocrinol 28.7 (2012): 509–15.
- Diamanti-Kandarakis, E., Dunaif, A. “Insulin resistance and polycystic ovary syndrome revisited: an update on mechanismsand implications.” Endocr Rev 33 (2012): 981–1030.
- Bevilacqua, A., Bizzarri, M. “Physiological role and clinical utility of inositols in polycystic ovary syndrome.” Best Pract Res Clin Obstet Gynaecol (2016). DOI: 10.1016/j. bpobgyn.2016.03.007
- Gromova, О.А., Torshyn, I.Y., Grishina, T.R. “Systematic analysis of molecular-physiological effects of myo-inositol: molecular biology, experimental and clinical medicine data.” Effective pharmacotherapy 28 (2013): 4–12.
- Saha, L., Kaur, S., Saha, P.K. “Pharmacotherapy of polycystic ovary syndrome: an update.” Fundam Clin Pharmacol 26.1 (2012): 54–62.
- Unfer, V., Carlomagno, G., Papaleo, E., et al. “Hyperinsulinemia Alters Myoinositol to d-chiroinositol Ratio in the Follicular Fluid of Patients With PCOS.” Reprod Sci 21.7 (2014): 854–8.
- Heimark, D., McAllister, J., Larner, J. “Decreased myo-inositol to chiro-inositol (M/C) ratios and increased M/C epimerase activity in PCOS theca cells demonstrate increased insulin sensitivity compared to controls.” Endocr J 61.2 (2014): 111–7.
- Bevilacqua, A., Carlomagno, G., Gerli, S., et al. “Results from the International Consensus Conference on myo-inositol and D-chiro-inositol in Obstetrics and Gynecology.” Assisted reproduction technology 31.6 (2015): 441–6.
- Nordio, M., Proietti, E. “The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone.” Eur Rev Med Pharmacol Sci 16.5 (2012): 575–81.
- Unfer, V., Carlomagno, G., Rizzo, P., et al. “Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial.” Eur Rev Med Pharmacol Sci 15.4 (2011): 452–7.
- Carlomagno, G., Unfer, V. “Inositol safety: clinical evidences.” Eur Rev Med Pharmacol Sci 15.8 (2011): 931–6.
- Unfer, V., Carlomagno, G., Dante, G., et al. “Effects of myo-inositol in women with PCOS: a systematic review of randomized controlled trials.” Gynecol Endocrinol 28.7 (2012): 509–15.
- Mashkina, E.V., Kovalenko, K.А., Gutnikova, L.V., et al. “Association of polymorphic genes of the folate cycle and integrins with miscarriage.” Medical genetics 1 (2013): 40–5.
- Thomson, R.L., Buckley, J.D., Brinkworth, G.D. “Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature.” Obes Rev 12 (2011): 202–10.
- Papaleo, E., Molgora, M., Quaranta, L., et al. “Myo-inositol products in polycystic ovary syndrome (PCOS) treatment: quality, labeling accuracy, and cost comparison.” Eur Rev Med Pharmacol Sci 15.2 (2011): 165–74.
- Baillargeon, J.P., Iuorno, M.J., Apridonidze, T., et al. “Uncoupling between insulin and release of a D-chiro-inositol-containing inositolphosphoglycan mediator of insulin action in obese women with polycystic ovary syndrome.” Metab Syndr Relat Disord 8.2 (2010): 127–36.
- Condorelli, R.A., La Vignera, S., Bellanca, S., et al. “Myo-inositol: does it improve sperm mitochondrial function and sperm motility?” Urology 79.6 (2012): 1290–5.
- Lisi, F., Carfagna, P., Oliva, M.M., et al. “Pretreatment with myo-inositol in non polycystic ovary syndrome patients undergoing multiple follicular stimulation for IVF: a pilot study.” Reprod Biol Endocrinol 10 (2012): 52.
- Ciotta, L., Stracquadanio, M., Pagano, I., et al. “Effects of myo-inositol supplementation on oocyte's quality in PCOS patients: a double blind trial.” Eur Rev Med Pharmacol Sci 15.5 (2011): 509–14.
- Venturella, R., Mocciaro, R., De Trana, E., et al. “Assessment of the modification of the clinical, endocrinal and metabolical profile of patients with PCOS syndrome treated with myo-inositol.” Minerva Ginecol 64.3 (2012): 239–43.
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