Cited by 115Ovarian function and disordersReproductive Biology and FertilityReproductive Health and Technologies

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Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials

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Pundir, J, Psaroudakis, D, Savnur, P, Bhide, P, Sabatini, L, Teede, H, Coomarasamy, A, Thangaratinam, S·2018·BJOG: An International Journal of Obstetrics & Gynaecology

DOI 10.1111/1471-0528.14754

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Abstract

Polycystic ovary syndrome is a common cause of anovulation and infertility, and a risk factor for development of metabolic syndrome and endometrial cancer. Systematic review and meta‐analysis of randomised controlled trials (RCT) that evaluated the effects of inositol as an ovulation induction agent. We searched MEDLINE, EMBASE, Cochrane and ISI conference proceedings, Register and Meta‐register for RCT and WHO trials’ search portal. We included studies that compared inositol with placebo or other ovulation induction agents. Quality of studies was assessed for risk of bias. Results were pooled using random effects meta‐analysis and findings were reported as relative risk or standardised mean differences. We included ten randomised trials. A total of 362 women were on inositol (257 on myo‐inositol; 105 on di‐chiro‐inositol), 179 were on placebo and 60 were on metformin. Inositol was associated with significantly improved ovulation rate (RR 2.3; 95% CI 1.1–4.7; I2 = 75%) and increased frequency of menstrual cycles (RR 6.8; 95% CI 2.8–16.6; I2 = 0%) compared with placebo. One study reported on clinical pregnancy rate with inositol compared with placebo (RR 3.3; 95% CI 0.4–27.1), and one study compared with metformin (RR 1.5; 95% CI 0.7–3.1). No studies evaluated live birth and miscarriage rates. Inositol appears to regulate menstrual cycles, improve ovulation and induce metabolic changes in polycystic ovary syndrome; however, evidence is lacking for pregnancy, miscarriage or live birth. A further, well‐designed multicentre trial to address this issue to provide robust evidence of benefit is warranted. Tweetable abstract: Inositols improve menstrual cycles, ovulation and metabolic changes in polycystic ovary syndrome

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2 retracted

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Background
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Background
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Background
Authors’ reply re: Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials
Pundir, J., Psaroudakis, D., Savnur, P., Bhide, P., Sabatini, L., Teede, H. J., Coomarasamy, A., & Thangaratinam, S. (2017) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14996 · Cited by 6
Self-citation
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“They have a favourable impact on the menstrual cycle regularity, carbohydrate metabolism, and the clinical and laboratory manifestations of hyperandrogenism (Pundir et al. 2018).”
Effect of non-pharmacological interventions for overweight/obese women with polycystic ovary syndrome on ovulation and pregnancy outcomes: a protocol for a systematic review and network meta-analysis
Yang, H., Xiao, Y.-Q., Liu, J., Xu, G., Li, J., Xiao, Z.-Y., Zhou, J., Zheng, X., Liu, L.-Y., Yu, Z., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-059090 · Cited by 5
Viscometric study of myo-inositol in aqueous deep eutectic solvent solutions
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Use of Inositols in Polycystic Ovary Syndrome
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Myoinositol supplementation on intracytoplasmic sperm injection outcome in Japanese infertile polycystic ovarian syndrome women with non-obese less-androgenic phenotype: a prospective controlled observational study
Kitaya, K., Takaya, Y., Nishiyama, R., Yamaguchi, K., Matsubayashi, H., Takeuchi, T., Mizuta, S., & Ishikawa, T. (2019) · Clinical and Experimental Obstetrics & Gynecology · doi:10.12891/ceog4567.2019 · Cited by 4
“In-deed, myoinositol supplementation is emerging as a promising tool to improve the ovulation disorders, oocyte quality, and pregnancy outcome in infertile PCOS women in Western countries [6].”
Background
New prospects of the integrative therapy for polycystic ovary syndrome in women with the disorders of carbohydrate and lipid metabolism: a comparative study
Dobrokhotova, Y. E., Лапина, И. А., Chirvon, T. G., & Таранов, В. В. (2020) · Russian Journal of Woman and Child Health · doi:10.32364/2618-8430-2020-3-3-169-173 · Cited by 4
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Naz, S., & Amerjee, A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-87932-3.00028-1 · Cited by 4
A retrospective study “myo-inositol is a cost-saving strategy for controlled ovarian stimulation in non-polycystic ovary syndrome art patients.”
Aragona, C., Russo, M., Myers, S. H., Espinola, M. S. B., Bilotta, G., & Unfer, V. (2025) · Health Economics Review · doi:10.1186/s13561-025-00609-8 · Cited by 3
“In this context, several studies demonstrated that inositol supplementation is useful for reestablishing the correct ratio myo-Ins/D-chiro-Ins, thus restoring the ovarian response to gonadotropins and a physiological menstrual cycle [35].”
Does MYO and ALA Supplementation Improve PCOS Outcomes?
Firat, S., Elter, K., Ateş, S., & Fisunoğlu, M. (2025) · Medicina · doi:10.3390/medicina61050885 · Cited by 4
“Inositol (myoinositol and di-chiroinositol) is a dietary supplement involved in insulin signal transduction as a secondary messenger and shown to be effective in the treatment of PCOS [14].”
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Le, N. S. V., Lê, M. T., & Cao, N. T. (2023) · Asian Pacific Journal of Reproduction · doi:10.4103/2305-0500.390300 · Cited by 4
Treatment Options for Managing Anovulation in Women with PCOS: An Extensive Literature Review of Evidence-Based Recommendations for Future Directions
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“This yielded an RR of 1.64 (95% CI 0.85–3.16) [23].”
Influential
Polycystic Ovarian Syndrome and Medically Assisted Reproduction
Mümüşoğlu, S., Sipahi, M., & Bozdağ, G. (2020) · Springer eBooks · doi:10.1007/978-981-15-2377-9_28 · Cited by 3
Endometrial and follicular development following stair-step and traditional protocols in women with polycystic ovary syndrome: An RCT
Shahgheibi, S., Seyedoshohadaei, F., Khezri, D., & Ghasemi, S. (2021) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.18502/ijrm.v19i6.9375 · Cited by 3
Optimization of ovarian function and metabolic status in syndrome of polycystic ovaries
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Insulin resistance as risk factor for the development of type 2 diabetes mellitus: a systematic approach
Schmiedt, R. A., Tiucă, R. A., Tilinca, R. M., Custură, L. M., Deteșan, O., Bacso, B. I., Abalasei, B. L., Bell, A. C., Streza, M. A., & Tilinca, M. C. (2021) · Acta Marisiensis. Seria Medica · doi:10.2478/amma-2021-0033 · Cited by 3
Effects of inositol in women with polycystic ovary syndrome: an umbrella review of meta-analyses from randomized controlled trials
Duan, M., Yang, M., Li, C., Wu, X. F., Yin, X., & Zhu, H. (2026) · Frontiers in Endocrinology · doi:10.3389/fendo.2026.1741509 · Cited by 2
Evidence-based recommendations for clinical practice (future directions: Research and practice)
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Modern approaches to the diagnosis and treatment of polycystic ovary syndrome in adolescence
Sergienko, M. Y., Sіusіuka, V. G., Makurina, G. I., Deinichenko, O. V., Kolokot, N. G., & Chornenka, A. S. (2022) · Reproductive health of woman · doi:10.30841/2708-8731.2.2022.261816 · Cited by 2
Management Options for Infertile Women with Polycystic Ovary Syndrome
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Pathogenesis of PCOS: From Metabolic and Neuroendocrine Implications to the Choice of the Therapeutic Strategy
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Re: Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials
Scioscia, M., Fascilla, F. D., & Bettocchi, S. (2017) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14810 · Cited by 2
Induction of ovulation
Naseem, H. S., & Abdallah, Y. (2021) · Obstetrics Gynaecology & Reproductive Medicine · doi:10.1016/j.ogrm.2021.03.002 · Cited by 1
Polikistik Over Sendromunda Güncel Terapötik Ajanlardan İnositol ve Alfa Lipoik Asit Takviyesi Üzerine Bir Derleme
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Comparison of different treatments used for polycystic ovary syndrome
Llamas, M. C., Montejano, J. M., Vergara, M. D. C. M., Muñoz, A. Z. C., Vargas, M. G. R., Otero, A. L., Martínez, L. A. P., Torres, J. M. Z., & Díaz, M. C. P. (2022) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20220207 · Cited by 1
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Pkhaladze, L., Unfer, V., & Dewailly, D. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-91673-8.00001-7 · Cited by 2
The role of inositol in improving fertility in patients with PCOS
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Ovulation induction in anovulatory PCOS women
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Inositol for women with polycystic ovary syndrome—possibly just better than placebo
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Authors' reply re: Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials
Pundir, J., Psaroudakis, D., Savnur, P., Bhide, P., Sabatini, L., Teede, H. J., Coomarasamy, A., & Thangaratinam, S. (2017) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14811 · Cited by 1
Self-citation
WITHDRAWN: Myoinositol supplementation for the prevention of gestational diabetes in at-risk patients. Systematic review and meta-analysis
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Retracted
Current Resources for Evidence-Based Practice, July 2018
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Das polyzystische Ovarsyndrom: Aktuelle Evidenz und praktische Empfehlungen
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Het polycystisch ovariumsyndroom: actuele richtlijnen voor diagnose in de eerste lijn en vruchtbaarheidsbehandeling
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A Study of Correlation between Abnormal Glucose Tolerance (AGT), Insulin Resistance (IR) and Abdominal Circumference (AC) in Young Girls with Polycystic Ovarian Syndrome at a Multi-Specialty Hospital in South Kolkata
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PCOS: komplementärmedizinische Behandlungsoptionen bei Mädchen und jungen Frauen
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Authors: Pundir, J., Psaroudakis, D., Savnur, P., Bhide, P., Sabatini, L., Teede, H., Coomarasamy, A., & Thangaratinam, S.
Affiliations: St Bartholomew's Hospital (GB)
Queen Mary University of London (GB)
Monash University (AU)
University of Birmingham (GB)
Corresponding author: Pundir, J
ORCID: Pundir, J
Bhide, P
Sabatini, L
Teede, H
Coomarasamy, A
Thangaratinam, S
Venue: BJOG: An International Journal of Obstetrics & Gynaecology
Publisher: Wiley
Published: 2017-07-14
Volume: 125
Issue: 3
Pages: 299-308
ISSN: 0306-5456 (ISSN-L)
1470-0328
1471-0528
DOI: 10.1111/1471-0528.14754
OpenAlex: W2619835212
Cited by: 115
References: 46
Citations by year: 2026: 8 · 2025: 10 · 2024: 3 · 2023: 16 · 2022: 14 · 2021: 16 · 2020: 19 · 2019: 9 · 2018: 16 · 2017: 4
FWCI: 2.14
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
PubMed (publishedVersion)
University of Birmingham Research Portal (University of Birmingham) (publishedVersion, other-oa)
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords: myo-inositol, polycystic ovary syndrome, anovulation, ovulation induction, metformin, menstrual cycle regularity, ovulation rate, infertility, clinical pregnancy
MeSH terms: Anovulation, Female, Humans, Infertility, Inositol, Polycystic Ovary Syndrome, Vitamin B Complex, Randomized Controlled Trials as Topic

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Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials

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