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Inositol treatment of anovulation in women with polycystic ovary syndrome: a meta‐analysis of randomised trials
Open accessAbstract
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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“They positively influence menstrual cycle regularity, carbohydrate metabolism, and the clinical and laboratory symptoms of hyperandrogenism (e.g., free testosterone, total testosterone, SHBG) [19].”
From Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [19]
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“However, the combined analysis of different inositols did not reach the level of significance.”
From Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials (2023) · cites this paper as [19]
Experimental — accuracy not yet measuredIn the citing paper
“Three reviews including a total of 62 trials with 5072 women with PCOS evaluated the efficacy of inositol in PCOS [47, 85, 86]. Endocrine outcomes were assessed by all the reviews with benefits reported in testosterone, dehydroepiandrosterone (DHEA), or androstenedione levels.”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [85]
In the citing paper
“Metabolic outcomes were assessed by all the reviews with important results: reduced insulin levels [47, 72, 85], reduced glucose levels and HOMA-IR, and improved blood pressure, triglycerides, and high-density lipoprotein [86].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [85]
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Endometrial function in women with polycystic ovary syndrome: a comprehensive review
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“[36], in their review, found that inositol supplementation appeared to increase the rates of ovulation and the frequency of menstrual cycles.”
BackgroundFemale Fertility and the Nutritional Approach: The Most Essential Aspects
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Metadata
- 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
- 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
- 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
- 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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