1
|
Inositol for the prevention of gestational diabetes: a systematic review and meta-analysis of randomized controlled trials. Arch Gynecol Obstet 2018; 299:55-68. [DOI: 10.1007/s00404-018-5005-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022]
|
2
|
Vitagliano A, Saccone G, Noventa M, Borini A, Coccia ME, Nardelli GB, Saccardi C, Bifulco G, Litta PS, Andrisani A. Pituitary block with gonadotrophin-releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta-analysis of randomised controlled trials. BJOG 2018; 126:167-175. [PMID: 29862633 DOI: 10.1111/1471-0528.15269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several randomised controlled trials (RCTs) have investigated the usefulness of pituitary block with gonadotrophin-releasing hormone (GnRH) antagonists during intrauterine insemination (IUI) cycles, with conflicting results. OBJECTIVE The aim of the present systematic review and meta-analysis of RCTs was to evaluate the effectiveness of GnRH antagonist administration as an intervention to improve the success of IUI cycles. SEARCH STRATEGY Electronic databases (MEDLINE, Scopus, EMBASE, Sciencedirect) and clinical registers were searched from their inception until October 2017. SELECTION CRITERIA Randomised controlled trials of infertile women undergoing one or more IUI stimulated cycles with GnRH antagonists compared with a control group. DATA COLLECTION AND ANALYSIS The primary outcomes were ongoing pregnancy/live birth rate (OPR/LBR) and clinical pregnancy rate (CPR). Pooled results were expressed as odds ratio (OR) or mean differences with 95% confidence interval (95% CI). Sources of heterogeneity were investigated through sensitivity and subgroups analysis. The body of evidence was rated using GRADE methodology. Publication bias was assessed with funnel plot, Begg's and Egger's tests. MAIN RESULTS Fifteen RCTs were included (3253 IUI cycles, 2345 participants). No differences in OPR/LBR (OR 1.14, 95% CI 0.82-1.57, P = 0.44) and CPR (OR 1.28, 95% CI 0.97-1.69, P = 0.08) were found. Sensitivity and subgroup analyses did not provide statistical changes in pooled results. The body of evidence was rated as low (GRADE 2/4). No publication bias was detected. CONCLUSION Pituitary block with GnRH antagonists does not improve OPR/LBR and CPR in women undergoing IUI cycles. TWEETABLE ABSTRACT Pituitary block with GnRH antagonists does not improve the success of IUI cycles.
Collapse
Affiliation(s)
- A Vitagliano
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| | - G Saccone
- Department of Neuroscience Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - M Noventa
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| | - A Borini
- 9.Baby, Family and Fertility Centre Bologna, Bologna, Italy
| | - M E Coccia
- Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynaecology, Careggi University Hospital, University of Florence, Florence, Italy
| | - G B Nardelli
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| | - C Saccardi
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| | - G Bifulco
- Department of Neuroscience Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | - P S Litta
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| | - A Andrisani
- Department of Women and Children's Health, Unit of Gynaecology and Obstetrics, University of Padua, Padua, Italy
| |
Collapse
|
3
|
Goyal M, Dawood AS. Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review. J Hum Reprod Sci 2017; 10:154-161. [PMID: 29142442 PMCID: PMC5672719 DOI: 10.4103/jhrs.jhrs_77_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS. The aim of this narrative review is to shed light on the debate prevailing regarding characteristics, as well as metabolic, hematological, and potential management modalities. Literature review was performed from January 1, 2000 to March 31, 2017 with specific word search such as lean PCOS, hormonal abnormalities in lean PCOS, and the management of lean PCOS. All retrieved articles were carefully assessed, and data were obtained. We could conclude that the debate is still prevailing regarding this specific lean population with PCOS, especially with regard to their characteristics and management modalities. Further studies are still required to resolve this debate on the presence of PCOS in lean women.
Collapse
Affiliation(s)
- Manu Goyal
- Department of Obstetrics and Gynecology, AIIMS, New Delhi, India
| | - Ayman S Dawood
- Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt
| |
Collapse
|
4
|
Bevilacqua A, Bizzarri M. Physiological role and clinical utility of inositols in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol 2016; 37:129-139. [DOI: 10.1016/j.bpobgyn.2016.03.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 03/09/2016] [Indexed: 11/16/2022]
|
5
|
Gizzo S, Noventa M, Quaranta M, Venturella R, Vitagliano A, Gangemi M, D'Antona D. New frontiers in human assisted reproduction - from research to clinical practice: Several considerations. Mol Med Rep 2016; 14:4037-4041. [DOI: 10.3892/mmr.2016.5749] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 08/22/2016] [Indexed: 11/06/2022] Open
|
6
|
Paul C, Laganà AS, Maniglio P, Triolo O, Brady DM. Inositol's and other nutraceuticals' synergistic actions counteract insulin resistance in polycystic ovarian syndrome and metabolic syndrome: state-of-the-art and future perspectives. Gynecol Endocrinol 2016; 32:431-8. [PMID: 26927948 DOI: 10.3109/09513590.2016.1144741] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The incidence of metabolic syndrome (MetS), type II diabetes (T2D) and polycystic ovarian syndrome (PCOS) has been progressively increasing. Insulin resistance (InsR) seems to play a key role in a majority of phenotypes of these conditions, altering metabolic homeostasis, within muscle, liver, adipose and other tissues. Hyperinsulinemia is often associated with InsR and causes hormonal imbalances especially within ovaries and adrenals. Inositol is a polyalcohol, naturally occurring as nine stereoisomers, including D-chiro-inositol (DCI) and myo-inositol (MI), which have prominent roles in the metabolism of glucose and free fatty acids. MI and DCI have been classified as insulin-sensitizers and seem to adequately counteract several InsR-related metabolic alterations with a safe nutraceutical profile. Based on our analysis of selected studies that investigated MI and/or DCI, we conclude that supplementation with MI and/or DCI complement each other in their metabolic actions and act in synergy with other insulin sensitizing drugs and/or nutraceuticals. Nevertheless, considering the possible severe bias due to different methodologies across published studies, we conclude that there is a need for further studies on larger cohorts and with greater statistical power. These should further clarify outcomes and suitable therapeutic dosages of MI and DCI, possibly based on each patient's clinical status.
Collapse
Affiliation(s)
- Cristiana Paul
- a Independent Nutrition Research Consultant , Los Angeles, CA , USA
| | - Antonio Simone Laganà
- b Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina , Messina , Italy
| | - Paolo Maniglio
- c Department of Obstetrics, Gynecology and Urology, Sant'Andrea Hospital , Sapienza University of Rome , Rome , Italy , and
| | - Onofrio Triolo
- b Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina , Messina , Italy
| | - David M Brady
- d Human Nutrition Institute, University of Bridgeport , Bridgeport, CT , USA
| |
Collapse
|
7
|
Helal MAM. The effects ofN-acetyl-l-cysteine on the female reproductive performance and nephrotoxicity in rats. Ren Fail 2016; 38:311-20. [DOI: 10.3109/0886022x.2015.1127742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
8
|
Noventa M, Quaranta M, Vitagliano A, Cinthya V, Valentini R, Campagnaro T, Marci R, Paola RD, Alviggi C, Gangemi M, Saccardi C, Nardelli GB, Gizzo S. May Underdiagnosed Nutrition Imbalances Be Responsible for a Portion of So-Called Unexplained Infertility? From Diagnosis to Potential Treatment Options. Reprod Sci 2015; 23:812-22. [PMID: 26692540 DOI: 10.1177/1933719115620496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the study was to investigate whether women affected by unexplained infertility may have undiagnosed dietary imbalances which negatively affect fertility. Secondarily, we investigated whether varying degrees of nutritional abnormalities may benefit from different periconceptional dietary supplementations, evaluating the most effective intervention in improving pregnancy rate after in vitro fertilization (IVF). We conducted a survey on 2 cohorts of patients (group A: unexplained infertility and group B: healthy first trimester spontaneous pregnancies) with the scope of investigating and comparing their dietary status discriminating women without dietary abnormalities (cohort 1) from those with abnormalities exclusively in micronutrient intake (cohort 2) or combined abnormalities in both micronutrient and macronutrient intake and associated obesity (cohort 3). All women included in group A were offered the opportunity to receive a prescription for one of the 3 designated daily dietary supplementation schemes (subgroups A1, A2, and A3) which were to be implemented in the 3 months immediately prior to beginning IVF treatment. When compared with fertile women, patients having unexplained infertility showed significant abnormalities in dietary habits. These differences ranged from a minimal imbalance in micronutrient intake (potentially avoidable with dietary supplementation) to severe combined macronutrient and micronutrient imbalance frequently associated with obesity (partially amendable by inositol supplementation and frequently requiring long-term dietary reeducation before establishment of fertility). Nutritional investigation and treatment may explain and resolve a portion of cases of unexplained infertility, improving the outcome of IVF treatment and, with minimal imbalances, likely restore spontaneous fertility.
Collapse
Affiliation(s)
- Marco Noventa
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Michela Quaranta
- Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy
| | | | - Vescio Cinthya
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | | | - Roberto Marci
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Rossana Di Paola
- Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy
| | - Carlo Alviggi
- Department of Neurosciences and Reproductive Science, University Federico II of Naples, Naples, Italy
| | - Michele Gangemi
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Carlo Saccardi
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | - Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Padua, Italy
| |
Collapse
|
9
|
Laganà AS, Triolo O, D’Amico V, Cartella SM, Sofo V, Salmeri FM, Vrtačnik Bokal E, Spina E. Management of women with epilepsy: from preconception to post-partum. Arch Gynecol Obstet 2015; 293:493-503. [DOI: 10.1007/s00404-015-3968-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 11/16/2015] [Indexed: 02/07/2023]
|
10
|
Gizzo S, Noventa M, Quaranta M, Vitagliano A, Esposito F, Andrisani A, Venturella R, Alviggi C, Plebani M, Gangemi M, Nardelli GB, D’Antona D. The Potential Role of GnRH Agonists and Antagonists in Inducing Thyroid Physiopathological Changes During IVF. Reprod Sci 2015; 23:515-23. [DOI: 10.1177/1933719115608000] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Marco Noventa
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Michela Quaranta
- Department of Obstetrics and Gynecology, University of Verona, Verona, Italy
| | | | - Federica Esposito
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | - Roberta Venturella
- Department of Obstetrics and Gynecology, University of Catanzaro, Catanzaro, Italy
| | - Carlo Alviggi
- Department of Neurosciences and Reproductive Science, University Federico II of Naples, Naples, Italy
| | - Mario Plebani
- Department of Laboratory Medicine, University of Padua, Padua, Italy
| | - Michele Gangemi
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | - Donato D’Antona
- Department of Woman and Child Health, University of Padua, Padua, Italy
| |
Collapse
|
11
|
Noventa M, Vitagliano A, Quaranta M, Borgato S, Abdulrahim B, Gizzo S. Preventive and Therapeutic Role of Dietary Inositol Supplementation in Periconceptional Period and During Pregnancy. Reprod Sci 2015; 23:278-88. [DOI: 10.1177/1933719115594018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Marco Noventa
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | | | - Michela Quaranta
- Department of Obstetrics and Gynaecology, University of Verona, Verona, Italy
| | - Shara Borgato
- Department of Woman and Child Health, University of Padua, Padua, Italy
| | - Baydaa Abdulrahim
- Department of Obstetrics and Gynecology, NHS Trust, Northampton General Hospital, Northampton, United Kingdom
| | - Salvatore Gizzo
- Department of Woman and Child Health, University of Padua, Padua, Italy
- Department of Obstetrics and Gynecology, NHS Trust, Northampton General Hospital, Northampton, United Kingdom
| |
Collapse
|
12
|
Gizzo S, Vitagliano A, Noventa M, Litta P, Saccardi C, Quaranta M. Surgery, endometriosis-related infertility and negative impact on ovarian reserve: “which came first, the hen or the egg?” An unresolved dilemma. Arch Gynecol Obstet 2015; 292:709-11. [DOI: 10.1007/s00404-015-3792-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/10/2015] [Indexed: 01/31/2023]
|