The Effect of L- Carnitine on Oocyte Maturity in Women with Polycystic Ovarian Syndrome Undergoing ICSI

Abstract

Due to malfunction of the hypothalamus-pituitary-ovary axis and probable dysregulation of ovarian activities such as follicle selection or follicular atresia, PCOS patients' ovary has a large amount of small follicles but no developed follicles. L-carnitine is a tiny, water-soluble chemical that plays a critical role in fat metabolism. It is required for appropriate mitochondrial fatty acid oxidation and acyl-CoA ester excretion, as well as affecting ATP levels. The study was conducted in High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University and Al-Farah private I.V.F center, 60 infertile women diagnosed with polycystic ovarian syndrome have been enrolled in this study and enter their IVF/ICSI cycle; they were informed about the study and signed a written informed consent. They were grouped into treatment group (n=30) who were treated with L-Carnitine® tablet for two months (VERO UNIVERSAL and NOW) and placebo group (n=30). All enrolled women underwent flexible antagonist protocol for ICSI. Significant increase in mean mature metaphase II (MII) oocyte count in study group than placebo group, 9.17 ±2.63 versus 7.27 ±3.49, respectively (p=0.021), oocyte maturity rate was significantly higher in study group in comparison with placebo group, 84.52 ±13.65 % versus 62.30 ±16.56 %, respectively (p < 0.001). In addition, mean fertilized (2PN) oocyte count was increased significantly in study group in comparison with placebo group, 7.93 ±2.63 versus 6.77 ±3.07, respectively (p=0.042). Mean fertilization rate was significantly higher in study group in comparison with placebo group, 66.79 ±14.05 % versus 56.67 ±19.05 %, respectively (p = 0.035).