Effect of Myo-Inositol in Combination with Alpha-Lipoic Acid and Cysteine (CelineTM) Based Co-Treatment on Oocyte Quality in Women with Polycystic Ovarian Syndrome Undergoing Assisted Reproductive Technology

Abstract

Background: Myo-inositol (MI), alone or in combination, has gained attention as a potential adjuvant therapy in women undergoing assisted reproductive techniques (ART). The aim of this study was to evaluate the effects of MI in combination with alpha-lipoic (ALA) and N-acetylcysteine (NAC) on oocyte quality and ART outcomes in women with polycystic ovary syndrome (PCOS). Methods: A total of 100 women with PCOS, aged 20-40 years and undergoing ART were randomly assigned to either the MI-ALA-NAC group (n=50) or the control group (n=50). The intervention group received daily oral supplementation of CelineTM (MI in combination with ALA and NAC) in addition to folic acid (FA) supplementation and standard ART treatment, while the control group received FA only in addition to standard treatment. The primary outcome measures included preovulatory follicle count, the number of mature oocytes retrieved, and embryo quality. The secondary outcomes were the number of gonadotropin vials used, ovarian stimulation duration, and pregnancy rate. Results: The Celine group demonstrated a significantly greater number of large sized follicles, oocytes retrieved, mature oocytes and improved embryo quality (p<0.05). Additionally, the Celine group exhibited shorter stimulation duration, reduced gonadotropin dose required, and higher pregnancy rate (p<0.005). Conclusions: MI in combination with ALA and NAC as an adjunct to ART among women with PCOS showed promising results in improving reproductive outcomes. Future studies should aim to expand our understanding of the long-term effects, and refine the clinical application of this MI co-treatment as an adjunct therapy in fertility clinics to improving the success rates and overall effectiveness of fertility treatments. Trial registration: PACTR, PACTR202401759325189. Registered 16 January 2024 - Retrospectively registered, https://pactr.samrc.ac.za/Search.aspx