ISSN 0300-9092 (Print)
ISSN 2412-5679 (Online)

Myoinositol and D-chiroinositol in the treatment of patients with anovulatory infertility associated with metabolic disorders: debatable issues

Dikke G.B., Dukhanin A.S.

1) F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; 2) N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia, Moscow, Russia

To date, a causal relationship between infertility and metabolic status has been established, but its importance for fertility is underestimated.
The objective of the review is to identify evidence of the efficacy and safety of dietary supplements containing myoinositol (MI) and D-chiroinositol (DCI), and their combinations in female infertility caused by metabolic disorders. The review included 57 publications that met the objective of the review. The analysis of experimental and clinical data showed that there is a large number of studies confirming the efficacy of MI and DCI for the treatment of a number of diseases associated with metabolic disorders, including anovulatory infertility in polycystic ovary syndrome (PCOS), obesity, etc. The comparative assessment of MI/DCI and metformin showed that both medications have comparable effectiveness in normalizing carbohydrate metabolism, reducing insulin resistance and lowering body mass index, but MI/DСI is superior to metformin in normalizing androgen status and the frequency of adverse events. The benefit of combined use of MI and DСI for restoring menstrual and reproductive functions has been identified. However, the optimal MI/DСI ratio, doses and clear indications have not yet been established due to the heterogeneity of studies.
Conclusion: Available clinical data suggest that MI, DСI and their combination with other supplements or their use without supplements improve metabolic and hormonal parameters and reproductive outcomes in patients with PCOS and/or obesity. The effect of inositol treatment on different PCOS phenotypes remains an unresolved issue. Further studies are required to improve the management of metabolic processes and restore ovulation. Thus, the optimal MI/DСI ratio and treatment regimens can be determined based on individual approaches depending on the characteristics of the disease.

Authors’ contributions: Dikke G.B., Dukhanin A.S. – developing the concept and design of the study, collecting and processing the material, statistical data processing and their interpretation, search for literary sources, writing the article, editing the article. The authors contributed equally to preparing and writing the article.
Conflicts of interest: The authors report no conflicts of interest.
Funding: The study was carried out at own expense. The publication of the article was supported by Invar LLC. The company’s employees did not participate in writing the text of the article or its editing.
For citation: Dikke G.B., Dukhanin A.S. Myoinositol and D-chiroinositol in the treatment of 
patients with anovulatory infertility associated with metabolic disorders: debatable issues.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (7): 175-186 (in Russian)
https://dx.doi.org/10.18565/aig.2025.173

Keywords

metabolic disorders
insulin resistance
hyperandrogenism
infertility
anovulation
polycystic ovary syndrome
obesity
myoinositol
D-chiroinositol

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Received 26.06.2025

Accepted 07.07.2025

About the Authors

Galina B. Dikke, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology with the Course of Reproductive Medicine, F.I. Inozemtsev Academy of Medical Education, 190013, Russia, St. Petersburg, Moskovsky Ave., 22, litera M, galadikke@yandex.ru, https://orcid.org/0000-0001-9524-8962
Aleksandr S. Dukhanin, Dr. Med. Sci., Professor at the Department of Molecular Pharmacology and Radiobiology, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 117513, Russia, Moscow, Ostrovityanov str., 1, das03du@mail.ru, https://orcid.org/0000-0003-2433-7727
Corresponding author: Galina B. Dikke, galadikke@yandex.ru

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