International Journal of Reproductive BioMedicine International Journal of Reproductive BioMedicine IJRM Medical Sciences http://ijrm.ir 1 admin 2476-4108 2476-3772 10.29252/ijrm en jalali 1404 2 1 gregorian 2025 5 1 23 5 online 1 fulltext
en تأثیر میو-اینوزیتول بر نتایج درمان کمک ‌باروری در زنان مبتلا به سندرم تخمدان پلی‌کیستیک: یک مرور نظام‌مند و متاآنالیز مطالعات کارآزمایی بالینی تصادفی‌سازی شده The effect of myo-inositol on assisted reproductive technology outcomes in women with polycystic ovarian syndrome: A systematic review and meta-analysis of randomized clinical trial studies Reproductive Biology Review article Review Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">یافته‌های متناقض حاصل از کارآزمایی‌های بالینی درباره اثرات میو-اینوزیتول و دی-کایرو-اینوزیتول بر نتایج درمان کمک ‌باروری در زنان مبتلا به سندرم تخمدان پلی‌کیستیک، انجام یک مرور نظام‌مند و متاآنالیز را ضروری می‌سازد.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف از انجام مطالعه<b> </b>ارزیابی تأثیر میو-اینوزیتول و دی-کایرو-اینوزیتول بر نتایج درمان کمک ‌باروری در زنان مبتلا به سندرم تخمدان پلی‌کیستیک بود</span></span><span lang="FA" style="font-size:10.0pt">.</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش&shy; ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">جستجوی جامعی در پایگاه‌های </span></span><span dir="LTR" style="font-size:10.0pt">PubMed</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:10.0pt">Scopus</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:10.0pt">Web of Science</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:10.0pt">EMBASE</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، </span></span><span dir="LTR" style="font-size:10.0pt">ClinicalTrials.gov</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> و&nbsp;&nbsp;</span></span><span dir="LTR" style="font-size:10.0pt">Cochrane</span> <span dir="LTR" style="font-size:10.0pt">Library</span><span style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> برای مطالعات منتشر شده از ژانویه 2000 تا ژانویه 2023 انجام شد. تحلیل‌های آماری با استفاده از نرم‌افزار </span></span><span dir="LTR" style="font-size:10.0pt">STATA</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> نسخه 17 صورت گرفت.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه، مجموعاً 17 مقاله مداخله &shy;ای در تحلیل نهایی در نظر گرفته شدند. مکمل میو-اینوزیتول/دی-کایرو-اینوزیتول به طور قابل توجهی میزان بارداری بالینی (32/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 5/%13 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">I<sup>2</sup></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 15/25-2/1 </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">CI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 95%، 64/1 </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">RR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و جنین&shy; های درجه یک (0001/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 43/%85 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">I<sup>2</sup></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 23/02-1/1 </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">CI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 95%، 12/1 </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">RR</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) را افزایش داد. هر چند این افزایش با کاهش تعداد فولیکول آنترال (001/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 37/%97 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">I<sup>2</sup></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 49/0-</span></span> <span dir="LTR" style="font-size:10.0pt">to</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">07/1- </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">CI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 95%، 78/0- </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">WMD</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و سطح آنتی&shy;مولرین هورمون (001/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 95/%91 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">I<sup>2</sup></span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">، 25/0-</span></span> <span dir="LTR" style="font-size:10.0pt">to</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">67/0- </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">CI</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> 95%، 46/0- </span></span><span lang="FA" style="font-size:10.0pt">:</span><span dir="LTR" style="font-size:10.0pt">WMD</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) همراه بود.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری: </span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">این متاآنالیز شواهد قابل اعتمادی در مورد اثرات میو-اینوزیتول/دی-کایرو-اینوزیتول بر باروری و عملکرد تخمدان در زنان مبتلا به سندرم تخمدان پلی‌کیستیک که تحت درمان‌های کمک‌باروری قرار دارند، ارائه می‌دهد.</span></span></div> <div style="text-align: justify;"><span style="font-size:14pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:12.0pt">Background:</span></b><span style="font-size:12.0pt"> Conflicting evidence from clinical trials on the effects of myo-inositol and D-chiro-inositol on assisted reproductive technology (ART) outcomes in women with polycystic ovarian syndrome (PCOS) necessitates a systematic review and meta-analysis.</span></span></span><br> <span style="font-size:14pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:12.0pt">Objective:</span></b><span style="font-size:12.0pt"> To evaluate the effect of myo-inositol and D-chiro-inositol on ART outcomes in women with PCOS. </span></span></span><br> <span style="font-size:14pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:12.0pt">Materials and Methods:</span></b><span style="font-size:12.0pt"> A comprehensive search was conducted in PubMed, Scopus, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Library for studies published from January 2000-2023. Statistical analyses were performed using STATA version 17.</span></span></span><br> <span style="font-size:14pt"><span new="" roman="" style="font-family:" times=""><b><span style="font-size:12.0pt">Results:</span></b><span style="font-size:12.0pt"> 17 intervention studies were included. myo-inositol/D-chiro-inositol supplementation significantly increased the clinical pregnancy rate (RR: 1.64, 95% CI: 1.25-2.15; I&sup2; = 13.5%; p = 0.32) and top-grade embryos (RR: 1.12, 95% CI: 1.02-1.23; I&sup2; = 85.43%; p = 0.0001). However, it was associated with reductions in antral follicle count (WMD: -0.78, 95% CI: -1.07 to -0.49; I&sup2; = 97.37%; p = 0.001) and anti-Mullerian hormone levels (WMD: -0.46, 95% CI: -0.67 to -0.25; I&sup2; = 91.95%; p = 0.001).</span></span></span><br> <b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> This meta-analysis provides reliable evidence on the effects of myo-inositol/D-chiro-inositol on fertility and ovarian function in women with PCOS undergoing ART.</span></span></div> دی-کایرو-اینوزیتول-گالاکتوزامین, اینوزیتول, روش‌های کمک‌باروری, سندرم تخمدان پلی‌کیستیک, ترکیب شواهد. D-chiro-inositol-galactosamine, Inositol, Assisted reproductive techniques, Polycystic ovarian syndrome, Evidence synthesis. 353 376 http://ijrm.ir/browse.php?a_code=A-10-1145-3&slc_lang=en&sid=1 Azadeh Akbari Sene doctor_asturias@yahoo.com 0009-0005-5553-0302 No Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran. Maryam Saeedzarandi m.saeedzarandi@gmail.com 0000-0002-4895-4730 No Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran. Maryam Yazdizadeh Maryam.yazdizade@gmail.com 0000-0001-7186-2271 No Department of Obstetrics and Gynecology, Medical School, Birjand University of Medical Sciences, Birjand, Iran. Seyede Razieh Ghaffari Raziehghaffari13851398@gmail.com 0009-0004-9475-4336 No Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran. Fatemehsadat Amjadi amjadi.bh@gmail.com 0000-0003-4902-388X No Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran. Zahra Zandieh zandie.dvm@gmail.com 0000-0002-7720-9465 No Shahid Akbar Abadi Clinical Research Development Unit (ShACRDU), School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran. Yousef Moradi Yousefmoradi211@yahoo.com 0000-0002-2936-5930 Yes Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.