Myo-inositol versus metformin effects on clinical features, endocrine and metabolic profiles in infertile women with polycystic ovary syndrome: A randomized controlled trial

Objective:To compare the effectiveness of inositol and metformin on the clinical characteristics,and endocrine and metabolic profiles of infertile polycystic ovarian syndrome(PCOS)women from Vietnam.Methods:From June 2018 to August 2022,a randomized trial was undertaken at the Hue Center for Endocrinology and Reproduction on infertile women aged 18 to 40 years with polycystic ovarian syndrome.The clinical,endocrine,and metabolic features of these individuals were assessed before and after 3 months of treatment with 2 g of inositol or 1700 mg of metformin per day.Natural pregnancy rates,adverse effects,and tolerance of inositol were recorded.Results:The study included 171 infertile PCOS women who were eligible to participate and took part in the baseline assessment,of whom 132 women participated in data analysis after 3 months.After metformin treatment,42.1%of women with oligomenorrhea experienced regular menstruation.Metformin significantly lowered body mass index(BMI),waist circumference and testosterone levels,but had no effect on other clinical characteristics,endocrine profiles,or metabolic profiles.29.2%Of women reported experiencing side effects.21%Of them attained pregnancy,which resulted in 17.1%of live births.In the inositol group,the rate of regular cycle increased by 18.2%and the total testosterone concentration significantly decreased.In overweight/obese women with PCOS,inositol significantly decreased weight,BMI,waist and hip circumferences(P<0.05).100%Of women tolerated inositol and continued treatment.18.9%Of them became pregnant,leading to 17%of live births.Conclusions:Metformin and inositol can improve weight and waist circumference in overweight/obese infertile women with PCOS.Metformin is associated with a higher rate of regular menstruation,whereas inositol is associated with a lower rate of adverse effects.The spontaneous conception,clinical pregnancy,and live birth rates between two groups are comparable.

Prolonged post-thaw culture of embryos does not improve outcomes of frozen human embryo transfer cycles: A prospective randomized study

Objective:To evaluate the impact of prolonged post-thaw embryos culture on pregnancy outcome during frozen embryo transfer cycles.Methods:This prospective cohort study evaluated 324 thaw transfer cycles with 819 embryos from 269 patients at the Center for Reproductive Endocrinology and Infertility of Hue University Hospital in Vietnam.These frozen embryo transfer cycles were divided into two groups at the time of thawing:the short culture group(2-hour post-thaw culture)and the overnight culture group(overnight culture for 18 h)before the embryo was transferred into the uterus.The rates of embryo intact,grade A embryo at frozen and transfer time and continuing cleavage were recorded.The clinical outcomes including serum beta-human chorionic gonadotropin,clinical pregnancy and implantation rate were evaluated after 14 days,4 weeks,6 weeks,respectively,after embryo transfer.Results:Human chorionic gonadotropin positive occurred in 39.5%of patients in the short culture group compared to 25.9%in the overnight culture group with risk difference(RD)=13.6%,relative risk(RR)=1.343,95%confidence interval(CI)1.085-1.663,P<0.01.Clinical pregnancy rate of the short culture group and overnight culture group was 33.3%and 24.1%,respectively(RD=9.2%,RR=1.242,95%CI 0.996-1.549,P=0.06)and the implantation rate in the short culture group and overnight culture group was 16.5%and 11.0%,respectively(RD=5.5%,RR=1.244,95%CI 1.046-1.479,P=0.01).In women of advanced age(≥35 years)and women who received 3 embryos,pregnancy outcomes were found to be significantly(P<0.05)higher in the short culture than in the overnight culture group.Conclusions:The prolonged post-thaw culture period does not increase pregnancy outcome in comparison with the short culture.