RESUMO
BACKGROUND: D-chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders. OBJECTIVES: This perspective seeks to explore the mechanisms and functions of D-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation. METHODS: A narrative review of all the relevant papers known to the authors was conducted. OUTCOME: D-chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue trans differentiation. These different modes of action have potential applications in a variety of therapeutic fields including: PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health. CONCLUSIONS: D-chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between D-chiro-inositol and its isomer myo-inositol. The insulin sensitizing activities of D-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.
RESUMO
The aim of this study is to evaluate the outcomes of single embryo transfer in patients with good ovarian reserve in the IVF program using time-lapse microscopy. This is a retrospective cohort study in a private IVF center in Russia. Comparison was done between 90 IVF cycles using time-lapse (study group) and 113 IVF cycles using standard culture (control group). Within each group, subgroups were selected with selective transfer of one embryo for 5 days (5SET) and elective transfer of one embryo for 5 days (5eSET). The primary outcome of the study was pregnancy rate. Secondary outcomes were miscarriage rates, live birth. Pregnancy rate did not significantly differ between the groups - 64.2% in the study group and control group. In the study group, the delivery rate was 54% in the subgroup 5eSET and 51.1% in the subgroup 5SET (p = .940). In the control group, the type of the embryo transfer significantly influenced on the delivery rate: in the 5eSET subgroup the birth rate was 54.4%, and in the 5SET subgroup it was 34.3% (p = .055; by Fisher's exact method p = .052). There were no adverse effects of the intervention. Selection of a single blastocyst based on information derived from time-lapse monitoring can help embryo selection for transfer.