Background: Polycystic ovarian syndrome (PCOS) is the most common cause of infertility, steroidogenesis and metabolic impairments, ovarian dysfunction and menstrual irregularity, affecting 5-10% of women in reproductive age. Inofolic is a combination of myo-inositol and folic acid, which improves pathological conditions associated with PCOS and improves fertility. Recently many authors have investigated whether supplementation with inofolic, improved the oocytes’ quality and increase the number of oocytes collected after ovarian stimulation in patients with PCOS undergoing in vitro fertilization. But so far, no study has examined the signaling pathway of inofolic on steroidogenesis in these patients.Objective: The aim of this study was to evaluate the effects of inofolic on oocyte quality, fertilization rate, embryo quality and steroidogenesis signaling pathway in cumulus cells of PCOS women undergoing ART cycles.Materials and Methods: Forty infertile PCOS patients were randomly designated into two groups and twenty cases was normal (control). In the first group, PCOS patients received daily doses of 4g
Myo-Inositol combined with 400mg folic acid and in other group patients received only 400mg folic acid from one month before starting the antagonist cycle until the day of ovum pick up. Normal group also received only 400mg folic acid from one month before starting the antagonist cycle until the day of ovum pick up. Oocytes and embryos quality were assessed according to European Society of Human Reproduction and Embryology (ESHRE) guidelines. The gene expression FSHR, CYP11A1, CYP19A1, ER, StAR, 3β-HSD2 in cumulus cells were analyzed using real-time RT-PCR.Results: The percentage of metaphase II oocyte, fertilization rate and embryo quality significantly improved in the study group which received inofolic (p<0.05), but the number of retrieved oocytes and follicle count were not statistically different between groups. Furthermore, the gene expression of FSHR, CYP11A1, CYP19A1, ER, StAR, 3β-HSD2 were significantly higher in the study group (p<0.05).Conclusion: The findings of our study provides some new molecular evidence about the possible mechanism of
Myo-Inositol effect on the fertilization rate, quality of oocytes and embryos. This might be related to modification of steroidogenesis pathway in cumulus cells of PCOS women undergoing ART cycles.