Abstract
Herein we aimed at assessing whether Myo-Inositol (MI), Alpha–Lipoic acid (ALA), and Folic acid (FA) could improve oocyte quality and embryo development in non-PCOS overweight/obese women undergoing IVF. Three hundred and twenty-four mature oocytes were obtained from non-PCOS overweight/obese patients, randomized to receive either MI, ALA, and FA (MI + ALA + FA group, n = 155 oocytes) or FA alone (FA-only group, n = 169 oocytes). Oocytes were examined using Polarized Light Microscopy to assess morphological features of zona pellucida (ZP) and meiotic spindle (MS). One hundred and seventy-six embryos (n = 84 in the MI + ALA + FA group, n = 92 in the FA-only group) were assessed by conventional morphology on days 2 and 5, as well as using the Time-Lapse System morphokinetic analysis. A significantly higher ZP retardance, area, and thickness (p < 0.05), and a shorter MS axis (p < 0.05) were observed in the MI + ALA + FA group, suggesting a positive effect on oocyte quality. Conventional morphology evaluation on day 2 showed a higher mean embryo score in the MI + ALA + FA group, whereas embryo morphokinetic was comparable in the two groups. Overall, our data show a possible beneficial effect of the combination of MI, ALA, and FA on oocyte and embryo morphology, encouraging testing of this combination in adequately powered randomized trials to assess their impact of clinical IVF results.
Highlights
Oocyte quality is a pivotal factor in determining IVF outcome, and the interest in the follicular microenvironment in which oocytes develop is witnessed by a series of recent studies [1,2,3]
The present study was designed as a pilot randomized prospective study aimed at clarifying whether this combination of nutraceuticals, given during three months preceding IVF, could affect measurable oocyte quality parameters assessed by Polarized Light microscopy (PLM) and/or embryo morphology and in vitro development kinetics evaluated by Time-Lapse system (TLS) analysis
A significantly larger endometrial thickness at oocyte pick-up (OPU) was observed in the MI +Alpha-Lipoic acid (ALA) + Folic acid (FA) group (11.4 ± 2.2 mm vs. 9.9 ± 1.8 mm; p < 0.05)
Summary
Oocyte quality is a pivotal factor in determining IVF outcome, and the interest in the follicular microenvironment in which oocytes develop is witnessed by a series of recent studies [1,2,3]. In addition to MI and FA, other molecules with antioxidant properties could improve oocyte competence: Alpha-Lipoic acid (ALA), which acts as a cofactor for pyruvate dehydrogenase, and Alpha-ketoglutarate dehydrogenase in mitochondria, which exerts a positive impact on the development of mouse pre-antral follicles [15]. The combination of three antioxidants (acetyl-L-carnitine, N-acetyl-L-cysteine, and ALA) has been shown to improve embryonic and foetal development in a murine IVF model, suggesting a positive effect on oocytes [16]. No studies so far investigated the effects of this combination on human oocytes and on human embryo development in non-PCOS overweight/obese women. The present study was designed as a pilot randomized prospective study aimed at clarifying whether this combination of nutraceuticals, given during three months preceding IVF, could affect measurable oocyte quality parameters assessed by Polarized Light microscopy (PLM) and/or embryo morphology and in vitro development kinetics evaluated by Time-Lapse system (TLS) analysis
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