Skip to main content
Top
Published in: Reproductive Health 1/2021

Open Access 01-12-2021 | ICSI | Review

Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies

Authors: Philippe Merviel, Pandora James, Sarah Bouée, Mathilde Le Guillou, Camille Rince, Charlotte Nachtergaele, Véronique Kerlan

Published in: Reproductive Health | Issue 1/2021

Login to get access

Abstract

Polycystic ovary syndrome (PCOS) is marked in 30 to 40% by insulin resistance and hyperandrogenism. Myo-inositol (MI) increases insulin sensitivity, decreases hyperandrogenism and improves the menstrual cycle. Its effect during assisted reproductive technologies (ART) has been studied by many authors. We conducted a review of the literature on the impact of MI administration in PCOS women in assisted reproductive technologies. Myo-inositol is effective in normalizing ovarian function, improving oocyte and embryo quality in PCOS, however further evaluations by large multicentre randomized controlled trials are needed to assess the clinical pregnancy and live birth rates in ART.
Literature
1.
go back to reference Merviel P, Bouée S, Ménard M, Le Martelot MT, Roche S, Lelièvre C, et al. Which ovarian stimulation to which women: the polycystic ovary syndrome (PCOS). Gynecol Obstet Fertil Senol. 2017;45:623–31.PubMed Merviel P, Bouée S, Ménard M, Le Martelot MT, Roche S, Lelièvre C, et al. Which ovarian stimulation to which women: the polycystic ovary syndrome (PCOS). Gynecol Obstet Fertil Senol. 2017;45:623–31.PubMed
2.
go back to reference Chiu TTY, Rogers MS, Law ELK, Britton-Jones CM, Cheung LP, Haines CJ. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF : relationship with oocyte quality. Hum Reprod. 2002;17:1591–6.CrossRef Chiu TTY, Rogers MS, Law ELK, Britton-Jones CM, Cheung LP, Haines CJ. Follicular fluid and serum concentrations of myo-inositol in patients undergoing IVF : relationship with oocyte quality. Hum Reprod. 2002;17:1591–6.CrossRef
3.
go back to reference Lagana AS, Garzon S, Casarin J, Franchi M, Ghazzi F. Inositol in polycystic ovary syndrome: restoring fertility through a pathophysiology-based approach. Trends Endocrinol Metab. 2018;29:768–80.CrossRef Lagana AS, Garzon S, Casarin J, Franchi M, Ghazzi F. Inositol in polycystic ovary syndrome: restoring fertility through a pathophysiology-based approach. Trends Endocrinol Metab. 2018;29:768–80.CrossRef
4.
go back to reference Gerli S, Papaleo E, Ferrari A, Di Renzo GC. Randomized, double-blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007;11:347–54.PubMed Gerli S, Papaleo E, Ferrari A, Di Renzo GC. Randomized, double-blind placebo-controlled trial: effects of myo-inositol on ovarian function and metabolic factors in women with PCOS. Eur Rev Med Pharmacol Sci. 2007;11:347–54.PubMed
5.
go back to reference Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res. 2002;3:47–60.CrossRef Larner J. D-chiro-inositol – its functional role in insulin action and its deficit in insulin resistance. Int J Exp Diabetes Res. 2002;3:47–60.CrossRef
6.
go back to reference Unfer V, Carlomagno G, Rizzo P, Raffone E, Roseff S. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles: a prospective, controlled, randomized trial. Eur Rev Med Pharm Sci. 2011;15:452–7. Unfer V, Carlomagno G, Rizzo P, Raffone E, Roseff S. Myo-inositol rather than D-chiro-inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles: a prospective, controlled, randomized trial. Eur Rev Med Pharm Sci. 2011;15:452–7.
7.
go back to reference Nordio M, Basciani S, Camajani E. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios. Eur Rev Med Pharmacol Sci. 2019;23:5512–21.PubMed Nordio M, Basciani S, Camajani E. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios. Eur Rev Med Pharmacol Sci. 2019;23:5512–21.PubMed
8.
go back to reference Zacche MM, Caputo L, Filippis S, Zacche G, Dindelli M, Ferrari A. Efficacy of myo-inositol in the treatment of cutaneous disorders on young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009;25:508–13.CrossRef Zacche MM, Caputo L, Filippis S, Zacche G, Dindelli M, Ferrari A. Efficacy of myo-inositol in the treatment of cutaneous disorders on young women with polycystic ovary syndrome. Gynecol Endocrinol. 2009;25:508–13.CrossRef
9.
go back to reference Minozzi M, Andrea GD, Unfer V. Treatment of hirsutism with myo-inositol : a prospective clinical study. Reprod Biomed Online. 2008;17:579–82.CrossRef Minozzi M, Andrea GD, Unfer V. Treatment of hirsutism with myo-inositol : a prospective clinical study. Reprod Biomed Online. 2008;17:579–82.CrossRef
10.
go back to reference Papaleo E, Unfer V, Baillargeon JP, De Santis L, Fusi F, Brigante C. Myo-inositol in patients with polycystic ovary syndrome : a novel method for ovulation induction. Gynecol Endocrinol. 2007;23:700–3.CrossRef Papaleo E, Unfer V, Baillargeon JP, De Santis L, Fusi F, Brigante C. Myo-inositol in patients with polycystic ovary syndrome : a novel method for ovulation induction. Gynecol Endocrinol. 2007;23:700–3.CrossRef
11.
go back to reference Papaleo E, Unfer V, Baillargeon JP, Fusi F, Occhi F, De Santis L. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles: a prospective, controlled, randomized trial. Fertil Steril. 2009;91:1750–4.CrossRef Papaleo E, Unfer V, Baillargeon JP, Fusi F, Occhi F, De Santis L. Myo-inositol may improve oocyte quality in intracytoplasmic sperm injection cycles: a prospective, controlled, randomized trial. Fertil Steril. 2009;91:1750–4.CrossRef
12.
go back to reference Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes : results from a randomized controlled trial. Arch Gynecol Obstet. 2013;288:1405–11.CrossRef Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes : results from a randomized controlled trial. Arch Gynecol Obstet. 2013;288:1405–11.CrossRef
13.
go back to reference Pacchiarotti A, Carlomagno G, Antonini G, Pacchairotti A. Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome. Gynecol Endocrinol. 2016;32:69–73.CrossRef Pacchiarotti A, Carlomagno G, Antonini G, Pacchairotti A. Effect of myo-inositol and melatonin versus myo-inositol, in a randomized controlled trial, for improving in vitro fertilization of patients with polycystic ovarian syndrome. Gynecol Endocrinol. 2016;32:69–73.CrossRef
14.
go back to reference Mendoza N, Perez L, Simoncini T, Genazzani A. Inositol supplementation in women with polycystic ovary syndrome undergoing intracytoplasmic sperm injection : a systematic review and meta-analysis of randomized controlled trials. Reprod Biomed Online. 2017;35:529–35.CrossRef Mendoza N, Perez L, Simoncini T, Genazzani A. Inositol supplementation in women with polycystic ovary syndrome undergoing intracytoplasmic sperm injection : a systematic review and meta-analysis of randomized controlled trials. Reprod Biomed Online. 2017;35:529–35.CrossRef
15.
go back to reference Lagana AS, Vitagliano A, Noventa M, Ambrosini G, D’Anna R. Myo-inositol 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. Arch Gynecol Obstet. 2018;298:675–84.CrossRef Lagana AS, Vitagliano A, Noventa M, Ambrosini G, D’Anna R. Myo-inositol 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. Arch Gynecol Obstet. 2018;298:675–84.CrossRef
16.
go back to reference Zheng X, Lin D, Zhang Y, Lin Y, Song J, Li S, et al. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. Medicine. 2017;96(49):e8842.CrossRef Zheng X, Lin D, Zhang Y, Lin Y, Song J, Li S, et al. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. Medicine. 2017;96(49):e8842.CrossRef
17.
go back to reference Carlomagno G, Unfer V, Roseff S. The D-chiro_inositol paradox in the ovary. Fertil Steril. 2011;95:2515–6.CrossRef Carlomagno G, Unfer V, Roseff S. The D-chiro_inositol paradox in the ovary. Fertil Steril. 2011;95:2515–6.CrossRef
18.
go back to reference Chiu TTY, Rogers MS, Briton-Jones C, Haines C. Effects of myo-inositol on the in-vitro maturation and subsequent development of mouse oocytes. Hum Reprod. 2003;18:408–16.CrossRef Chiu TTY, Rogers MS, Briton-Jones C, Haines C. Effects of myo-inositol on the in-vitro maturation and subsequent development of mouse oocytes. Hum Reprod. 2003;18:408–16.CrossRef
19.
go back to reference Sene AA, Tabatabaie A, Nikniaz H, Alizadeh A, Sheibani K, Alisaraie MM, et al. The myo-inositol effect on the oocyte quality and fertilization rate among women with polycystic ovary syndrome undergoing assisted reproductive technology cycles : a randomized clinical trial. Arch Gynecol Obstet. 2019;299:1701–7.CrossRef Sene AA, Tabatabaie A, Nikniaz H, Alizadeh A, Sheibani K, Alisaraie MM, et al. The myo-inositol effect on the oocyte quality and fertilization rate among women with polycystic ovary syndrome undergoing assisted reproductive technology cycles : a randomized clinical trial. Arch Gynecol Obstet. 2019;299:1701–7.CrossRef
20.
go back to reference Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome: a randomized study. Gynecol Endocrinol. 2013;29:375–9.CrossRef Artini PG, Di Berardino OM, Papini F, Genazzani AD, Simi G, Ruggiero M, et al. Endocrine and clinical effects of myo-inositol administration in polycystic ovary syndrome: a randomized study. Gynecol Endocrinol. 2013;29:375–9.CrossRef
21.
go back to reference Mendoza N, Diaz-Ropero MP, Aragon M, Maldonado V, Llaneza P, Lorente J, et al. Comparison of the effect of two combinations of myo-inositol and D-chiro-inositol in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecol Endocrinol. 2019;35:695–700.CrossRef Mendoza N, Diaz-Ropero MP, Aragon M, Maldonado V, Llaneza P, Lorente J, et al. Comparison of the effect of two combinations of myo-inositol and D-chiro-inositol in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecol Endocrinol. 2019;35:695–700.CrossRef
22.
go back to reference Mendoza N, Galan MI, Molina C, Mendoza-Tesarik R, Conde C, Mazheika M, et al. High dose of d-chiro-inositol improves oocyte quality in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecol Endocrinol. 2020;36:398–401.CrossRef Mendoza N, Galan MI, Molina C, Mendoza-Tesarik R, Conde C, Mazheika M, et al. High dose of d-chiro-inositol improves oocyte quality in women with polycystic ovary syndrome undergoing ICSI: a randomized controlled trial. Gynecol Endocrinol. 2020;36:398–401.CrossRef
23.
go back to reference Bhide P, Pundir J, Gudi A, Shah A, Homburg R, Acharya G. The effect of myo-inositol/di-chiro-inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019;98:1235–44.CrossRef Bhide P, Pundir J, Gudi A, Shah A, Homburg R, Acharya G. The effect of myo-inositol/di-chiro-inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019;98:1235–44.CrossRef
24.
go back to reference Showell MG, Mackenzie-Proctor R, Jordan V, Hodgson R, Farquhar C. Inositol for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2018;8:012378. Showell MG, Mackenzie-Proctor R, Jordan V, Hodgson R, Farquhar C. Inositol for subfertile women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2018;8:012378.
25.
go back to reference Turan GA, Eskicioglu F, Sivrikoz N, Cengiz H, Adakan S, Gur EB, et al. Myo-inositol is a promising treatment for the prevention of ovarian hyperstimulation syndrome (OHSS): an animal study. Arch Gynecol Obstet. 2015;292:1163–71.CrossRef Turan GA, Eskicioglu F, Sivrikoz N, Cengiz H, Adakan S, Gur EB, et al. Myo-inositol is a promising treatment for the prevention of ovarian hyperstimulation syndrome (OHSS): an animal study. Arch Gynecol Obstet. 2015;292:1163–71.CrossRef
26.
go back to reference Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol. 2010;26:275–80.CrossRef Raffone E, Rizzo P, Benedetto V. Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women. Gynecol Endocrinol. 2010;26:275–80.CrossRef
27.
go back to reference Morgante G, Orvieto R, Di Sabatino A, Musacchio MC, De Leo V. The role of inositol supplementation in patients with polycystic ovary syndrome, with insulin resistance, undergoing the low-dose gonadotropin ovulation induction regimen. Fertil Steril. 2011;95:2642–4.CrossRef Morgante G, Orvieto R, Di Sabatino A, Musacchio MC, De Leo V. The role of inositol supplementation in patients with polycystic ovary syndrome, with insulin resistance, undergoing the low-dose gonadotropin ovulation induction regimen. Fertil Steril. 2011;95:2642–4.CrossRef
28.
go back to reference Ozay OE, Ozay AC, Cagliyan E, Okyay RE, Gulekli B. Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome : A prospective, controlled, randomized trial. Gynecol Endocrinol. 2017;33:524–8.CrossRef Ozay OE, Ozay AC, Cagliyan E, Okyay RE, Gulekli B. Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome : A prospective, controlled, randomized trial. Gynecol Endocrinol. 2017;33:524–8.CrossRef
29.
go back to reference Agrawal A, Mahey R, Kachhawa G, Khadgawat R, Vanamail P, Kriplani A. Comparison of metformine plus myo-inositol vs metformine alone in PCOS women undergoing ovulation induction cycles : Randomized controlled trial. Gynecol Endocrinol. 2019;35:511–4.CrossRef Agrawal A, Mahey R, Kachhawa G, Khadgawat R, Vanamail P, Kriplani A. Comparison of metformine plus myo-inositol vs metformine alone in PCOS women undergoing ovulation induction cycles : Randomized controlled trial. Gynecol Endocrinol. 2019;35:511–4.CrossRef
30.
go back to reference Ciotta L, Stracquadanio M, Pagano I, Carbonaro A, Palumbo M, Gulino F. Effects of myo-inositol supplementation on oocyte’s quality in PCOS patients : A double blind trial. Eur Rev Med Pharm Sci. 2011;15:509–14. Ciotta L, Stracquadanio M, Pagano I, Carbonaro A, Palumbo M, Gulino F. Effects of myo-inositol supplementation on oocyte’s quality in PCOS patients : A double blind trial. Eur Rev Med Pharm Sci. 2011;15:509–14.
31.
go back to reference Lesoine B, Regidor PA. Prospective randomized study on the influence of myo-inositol in PCOS women undergoing IVF in the improvement of oocyte quality, fertilization rate, and embryo quality. Int J Endocrinol. 2016;2016:4378507.CrossRef Lesoine B, Regidor PA. Prospective randomized study on the influence of myo-inositol in PCOS women undergoing IVF in the improvement of oocyte quality, fertilization rate, and embryo quality. Int J Endocrinol. 2016;2016:4378507.CrossRef
Metadata
Title
Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies
Authors
Philippe Merviel
Pandora James
Sarah Bouée
Mathilde Le Guillou
Camille Rince
Charlotte Nachtergaele
Véronique Kerlan
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2021
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-021-01073-3

Other articles of this Issue 1/2021

Reproductive Health 1/2021 Go to the issue