How Myo-Inositol Can Support Fertility in Women with PCOS
Polycystic ovarian syndrome (PCOS) is the most common cause of ovulatory dysfunction infertility and is estimated to impact between 6-12% of the population! PCOS is diagnosed based on the Rotterdam criteria which require women to present with 2 of the 3 following criteria for a formal diagnosis:
Polycystic ovaries on ultrasound
Clinical symptoms or labs indicating high androgen hormone levels
Irregular cycles (cycles longer than 35 days, or shorter than 21 days)
Because PCOS is a syndrome, not all women with PCOS will have the same signs and symptoms and PCOS drivers. Treating a unique individual based on their type of PCOS is critical to proper care.
Many women with PCOS have insulin signaling issues, commonly known as insulin resistance, as a major driver of their PCOS symptoms. Myo-inositol supplementation has been found to support healthy insulin levels, improve ovulation rates, and reduce testosterone levels in women with PCOS.
Considering myo-inositol's positive impact on these important markers, investigating its use when it comes to fertility is of interest. Research suggests that myo-inositol supplementation may positively impact fertility outcomes in women going through fertility treatment with PCOS in multiple ways!
What Is Myo-Inositol?
Myo-inositol is a sugar the body produces, which can be found in food, that acts as a signaling molecule in the body. Myo-inositol has been found to regulate several hormones including the thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH) and insulin hormones.
Due to its insulin-sensitizing action, myo-inositol is becoming a commonly prescribed supplement to support metabolic disorders related to insulin resistance including metabolic syndrome, diabetes and PCOS.
Myo-Inositol & Fertility
Several studies have investigated myo-inositol’s effect on fertility outcomes and found positive impacts when it comes to egg and embryo quality, pregnancy rates, reduced side effects of IVF medications and even reduced doses of medications needed.
One study found that myo-inositol was just as effective as metformin (a common medication prescribed in those with PCOS) in reducing ovulation hyperstimulation syndrome (OHSS) in women with PCOS going through an IVF cycle. This same study found that the myo-inositol group had higher rates of pregnancy and good quality embryos compared to the metformin group.
Myo-inositol also may improve fertility outcomes by positively impacting egg and embryo quality. One study gave women who had a previously failed IVF cycle due to poor egg quality 4g of myo-inositol plus 3mg of melatonin per day for 3 months before going through a new IVF cycle. The study found that after supplementing with the myo-inositol and melatonin mixture, women had a statistically higher number of mature eggs, fertilization rate and total and top embryos transferred.
Yet another study found that 2g of myoinositol led to increased numbers of mature eggs during simulation and pick up and reduced number of immature eggs.
In addition to these positive impacts on OHSS side effects, egg and embryo quality and pregnancy rates, myoinositol has also been found to reduce the need for medication in an IVF cyce. One study found that myoinositol increased the sensitivity of polycystic ovaries to gonadotropin hormones, leading to a reduced need for FSH.
Is Myo-Inositol Right For You?
Like most things when it comes to health, there’s no one size fits all treatment and whether a supplement or medication is right for you completely depends on your unique case and health.
If you’re considering taking myo-inositol, speak to a practitioner first to make sure it’s a safe and effective option. The dose, quality of the product, potential side effects and medication interactions all need to be considered before starting any natural health care product.
Looking For More Fertility Support?
Understanding how to optimize your fertility, reduce miscarriage risk and support yourself for the healthiest pregnancy and postpartum period is incredibly important! Naturopathic medicine has many tools that can support you along your fertility journey. You can read more about our fertility approach here, and reach out to the clinic if you have any questions!
References:
Unfer, V., Facchinetti, F., Orrù, B., Giordani, B., & Nestler, J. (2017). Myo-inositol effects in women with PCOS: a meta-analysis of randomized controlled trials. Endocrine Connections, 6(8), 647-658. doi: 10.1530/ec-17-0243
Rajasekaran, Keerthana, et al. “Myoinositol versus Metformin Pretreatment in Gnrh-Antagonist Cycle for Women with PCOS Undergoing IVF: A Double-Blinded Randomized Controlled Study.” Gynecological Endocrinology, vol. 38, no. 2, 2021, pp. 140–147., https://doi.org/10.1080/09513590.2021.1981282.
Unfer, Vittorio, et al. “Effect of a Supplementation with Myo-Inositol plus Melatonin on Oocyte Quality in Women Who Failed to Conceive in Previousin VitroFertilization Cycles for Poor Oocyte Quality: A Prospective, Longitudinal, Cohort Study.” Gynecological Endocrinology, vol. 27, no. 11, 2011, pp. 857–861., https://doi.org/10.3109/09513590.2011.564687.
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 Pharmacol Sci. 2011 May;15(5):509-14. PMID: 21744744.