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

Abstract

Inositols improve menstrual cycles, ovulation and metabolic changes in polycystic ovary syndrome.

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

“…An explanation for similar clinical outcomes obtained with myoinositol may result from the conversion of myo-inositol into D-chiro-inositol by an insulin-inducible NAD/NADH epimerase. 2 This hypothesis is strongly supported by the evidence that all clinical studies with myo-inositol used dosages as high as 2-4 g per day, whereas lower doses of D-chiro-inositol (0.5-1.2 g) are sufficient to restore insulin sensitivity, to improve ovulatory function, and to reduce the level of androgens in women with PCOS.…”

“…Nevertheless, the two inositol glycans (in vivo active forms) are insulin mimetic when administered both in vitro and in vivo, but with specific activities as D-chiro-inositol-glycan promotes glucose uptake and catabolism, whereas myo-inositol-glycan induces glycogen synthesis. 2 Although both inositols have been largely used in PCOS with similar results (for example, the risk ratio for the ovulation rate is reported as 1.03 in Pundir et al 1 ), it should be clear that Dchiro-inositol is the actual active molecule to achieve insulin homeostasis and to correct hormonal disturbances (hyperinsulinemia with secondary FSH/ LH ratio anomalies and excess of androgens), otherwise we could not explain why we obtain good clinical results with classical insulin-sensitiser agents in such patients. An explanation for similar clinical outcomes obtained with myoinositol may result from the conversion of myo-inositol into D-chiro-inositol by an insulin-inducible NAD/NADH epimerase.…”

“…Authors' reply Sir, We thank Scioscia et al 1 for their interest in our article. 2 Our aim was to assess the overall effects of the inositol polymers on fertility-related outcomes in women with polycystic ovary syndrome (PCOS). We meta-analysed the effects of both inositol polymers in separate subgroups, and have also provided overall summary estimates for www.bjog.org their effects on ovulation induction.…”

Author's reply re: Changes in anti‐müllerian hormone levels as a biomarker for ovarian reserve after ultrasound‐guided high‐intensity focused ultrasound treatment of adenomyosis and uterine fibroid

“…We were surprised at the tweetable abstract 'Inositols improve menstrual cycles, ovulation and metabolic changes in polycystic ovary syndrome' from the systematic review by Pundir et al 1 Although the abstract and the conclusion included the qualifier 'appears to' this is, in our opinion, much too strong a statement. Not only was the review itself seemingly unregistered, but neither were any of the included trials.…”

“…Re: Changes in anti-m€ ullerian hormone levels as a biomarker for ovarian reserve after ultrasoundguided high-intensity focused ultrasound treatment of adenomyosis and uterine fibroid Sir, I read with interest the recently published article by Lee et al, 1 which evaluated the changes in anti-m€ ullerian hormone (AMH) levels as a biomarker for ovarian reserve after ultrasound-guided highintensity focused ultrasound (HIFU) treatment in a prospective cohort of 79 women. The clinical application of HIFU in the treatment of fibroids and adenomyosis in most countries, other than in China, is still considered novel.…”