Skip to main content Skip to main navigation menu Skip to site footer
Review
Published: 03-30-2022

Myo-inositol in polycystic ovary syndrome: a systematic review and positioning of its use

UNIFIPA - Padre Albino University Center, Medicine Course, Catanduva, São Paulo, Brazil
UFSCAR - Federal University of Sao Carlos, department of medicine, Sao Carlos, Sao Paulo, Brazil
FACERES - Faculty of Medicine of Sao Jose do Rio Preto, Sao Paulo, Brazil
Inositol Myo-inositol Gestational diabetes Fertility Polycystic ovary syndrome Insulin resistance

Abstract

Introduction: Polycystic Ovary Syndrome (PCOS) is the most common endocrine disease among women of reproductive age 6 to 15% its presentation is complex and heterogeneous and is characterized by clinical and laboratory findings of hyperandrogenism, oligo-anovulation, metabolic abnormalities such as insulin resistance (IR), overweight, obesity, type 2 diabetes mellitus, dyslipidemia and increased risk of cardiovascular disease. Objective: To evaluate the effects of myo-inositol in pregnant and non-pregnant women with polycystic ovary syndrome in relation to fertility improvement, gestational outcomes, and metabolic and hormonal parameters. Methods: Data from randomized clinical trials on the efficacy of myo-inositol in women with PCOS were used in this review. The PubMed database was used for literature search. Results: Insulin resistance is one of the mechanisms that explain the emergence of metabolic and reproductive changes in women with PCOS. When compared to placebo, myo-inositol was effective in improving fertility, increasing ovulation and fertilization rates, in addition to improving metabolic parameters as indicators of insulin resistance (HOMA index). Even when compared to more traditional insulin sensitizers like metformin, myoinositol showed similar efficacy in restoring fertility. Myo-inositol was also effective when associated with clomiphene acetate and in women undergoing in vitro fertilization processes. There was also an improvement in pregnancy outcomes and a reduction in the risk of developing gestational diabetes with the use of myo-inositol. Conclusions: Myo-inositol improves clinical and laboratory parameters in both pregnant and non-pregnant PCOS patients, increasing the fertility rate and improving pregnancy outcomes.

Metrics

Metrics Loading ...

References

  1. Kamenov Z, Gateva A. Inositols in PCOS. Molecules 2020, 25, 5566;
  2. Moghetti P. Tosi F. Insulin resistance and PCOS: chicken or egg?Journal of Endocrinological Investigation. Published on line 09 July 2020.
  3. Gardner DG, Shoback D. Greenspan's Basic & Clinical Endocrinology, 10e Capítulo 13, pag 466-468.
  4. Facchinetti F. et al. Inositols in Polycystic Ovary Syndrome:An Overview on the Advances. Trends in Endocrinology & Metabolism, Trends Endocrinol Metab. 2020 Jun;31(6):435-447. doi: 10.1016/j.tem.2020.02.002. Epub 2020 Mar 9.
  5. Zeng X. et al. Polycystic Ovarian Syndrome: Correlation Between Hyperandrogenism, Insulin Resistance and Obesity. Clinica Chimica Acta, 4 November 2019. DOI: https://doi.org/10.1016/j.cca.2019.11.003.
  6. Costantino D. et al. Metabolic and hormonal effects of myo-inositol in women with polycystic ovary syndrome: A double-blind trial., C. Guaraldiarticle in European Review for Medical and Pharmacological Sciences · March 2009.
  7. Regidor PA, Schindler AE. Myoinositol as a Safe and Alternative Approach in the Treatment of Infertile PCOS Women: A German Observational Study. International Journal of Endocrinology Volume 2016.
  8. Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecological Endocrinology, April 2010; 26(4): 275–280.
  9. Zeng L; Yang K. Effectiveness of myoinositol for polycystic ovary syndrome: a systematic review and meta-analysis. Endocrine DOI 10.1007/s12020-017-1442-y. September 2017.
  10. Zheng et al. Inositol supplement improves clinical pregnancy rate in infertile women un/dergoing ovulation induction for ICSI or IVF-ET. Medicine (2017) 96:49.
  11. Kamenov Z et al. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol, Early Online: 1–5. DOI: 10.3109/09513590.2014.964640
  12. Zheng X. et al. Relationship Between Myo-Inositol Supplementary and Gestational Diabetes Mellitus. Medicine Volume 94, Number 42, October 2015.
  13. Guo X, Guo S, Miao Z. et al. Myo-inositol lowers the risk of developing gestational diabetic mellitus in pregnancies: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis. Journal of Diabetes and Its Complications. 17 July 201710.1016/j.jdiacomp.2017.07.007.
  14. Zhang H, Lv Y, Li Z, Sun L, Guo W. The efficacy of myo-inositol supplementation to prevent gestational diabetes onset: a metaanalysis of randomized controlled trials. The Journal of Maternal-Fetal & Neonatal Medicine ISSN: 1476-7058 (Print) 1476-4954 (Online) Journal homepage: http://www.tandfonline.com/loi/ijmf20.
  15. Laganà AS, Vitagliano A, Noventa M. et al. Myoinositol supplementation reduces the amount of gonadotropins and length of ovarian stimulation in women undergoing IVF:a systematic review and meta‑analysis of randomized controlled trials. Archives of Gynecology and Obstetrics https://doi.org/10.1007/s00404-018-4861-y
  16. Carlomagno G, Unfer V. Inositol safety: clinical evidences European Review for Medical and Pharmacological Sciences. 2011; 15: 931-936.

How to Cite

Ribas Filho, D., Nogueira-de-Almeida, C. A., & Zotarelli-Filho, I. J. (2022). Myo-inositol in polycystic ovary syndrome: a systematic review and positioning of its use. International Journal of Nutrology, 15(2). https://doi.org/10.54448/ijn22201