ANALYSIS OF INOSITOL SUPPLEMENTATION FOR IMPROVING OVARIAN RESPONSE IN POOR RESPONDERS UNDERGOING IN VITRO FERTILIZATION: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Poor ovarian response remains a major challenge in assisted reproductive technology, often resulting in low oocyte yield and reduced pregnancy rates. Conventional stimulation strategies frequently fail to produce meaningful improvements, prompting interest in adjunct therapies that may enhance oocyte quality. Myo-inositol, a naturally occurring molecule involved in intracellular signaling, has shown potential benefits in ovarian physiology, yet evidence in poor responders remains limited.

Objective: To evaluate whether myo-inositol supplementation prior to ovarian stimulation improved the number of mature oocytes retrieved and clinical pregnancy rates in women with poor ovarian response undergoing in vitro fertilization.

Methods: A randomized controlled trial was conducted among women meeting established criteria for poor ovarian response. Participants were allocated to receive either myo-inositol with folic acid or folic acid alone for eight weeks before controlled ovarian stimulation using a standardized antagonist protocol. Ovarian response was monitored via transvaginal ultrasonography and hormonal assessment. Mature oocytes were identified morphologically at retrieval, embryo quality was graded on day 3, and clinical pregnancy was confirmed by ultrasound visualization of a gestational sac with cardiac activity. Statistical analysis included independent t-tests, chi-square tests, and Pearson correlation, with significance set at p < 0.05.

Results: Women receiving myo-inositol demonstrated a significantly higher mean number of mature oocytes compared with controls. Improved embryo quality and a higher clinical pregnancy rate were also observed in the intervention group. Positive correlations were found between inositol supplementation and markers of ovarian response, while age showed a negative association.

Conclusion: Myo-inositol supplementation was associated with enhanced ovarian responsiveness and improved clinical outcomes in poor responders undergoing in vitro fertilization, suggesting its value as a supportive adjunct to conventional stimulation protocols.