EXPERIENCE OF MYO-INOSITOL USE IN PATIENTS OF ADVANCED REPRODUCTIVE AGE UNDERGOING ASSISTED REPRODUCTION

The effectiveness of infertility treatment using assisted reproductive technologies (ART) is lower in patients of advanced reproductive age compared to women under 35 years of age. Objective: To evaluate the outcomes of in vitro fertilization (IVF) programs after administration of the combination of myo-inositol (MI) + α-lactalbumin (α-LA) in the preconception period in patients of advanced reproductive age. Materials and methods: A total of 167 patients were selected for the study according to the inclusion criteria. Group 1 consisted of 68 patients who received a combination of MI 600 mg + α-LA + folic acid 200 mcg (Inofert Forte) 1 capsule twice a day, orally, 3 months before the IVF program. Group 2 included 99 patients who received folic acid 400 mcg per day, orally, for 3 months. Controlled ovarian stimulation was performed according to the standard protocol in both groups. Results: The average total dose of gonadotropins per treatment cycle of ovarian stimulation was lower in the main group and it was 2000 (1575; 2450) IU versus 2150 (1900; 2500) IU in the control group (p=0.037). The percentage of embryos reaching the blastocyst stage in the main group was significantly higher than in the control group and it was 69.1% versus 50.1% (p<0.001); the average number of obtained blastocysts was also significantly higher in the main group, namely 2.82 (2.8) (95% CI: 2.15–3.5) versus 2.01 (1.9) (95% CI: 1.63–2.39), respectively (p=0.026). The clinical pregnancy rate in the frozen-thawn embryo transfer cycles was significantly higher in the main group and it was 13/18 (72.2%) versus 7/22 (31.8%) in the control group (p=0.028). The outcome measure for achieving clinical pregnancy was 56.3% in the main group and 38.3% in the control group (p=0.32). The present study found that the likelihood of pregnancy resulting from the transfer of frozen-thawed embryos was 3.1 times higher after MI + α-LA supplementation in the preconception period of an IVF program than in the absence of such supplementation (95% CI: 1.2–8.3). The chance of pregnancy ending in childbirth was 3 times higher (95% CI: 1.05-8.53) with MI supplementation before IVF (p=0.04). Conclusion: The combination of MI 600 mg + α-LA + folic acid 200 µg (Inofert Forte) may be a simple and effective solution when preparing patients of advanced reproductive age for IVF programs since it helps to reduce the total dose of gonadotropins, improve embryological parameters and increase the effectiveness of ART programs. © 2025 Elsevier B.V., All rights reserved.