Updates on the myo-inositol plus D-chiro-inositol combined therapy in polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. It is characterized by chronic anovulation, hyperandrogenism, and insulin resistance. It is the main cause of infertility due to the menstrual dysfunction and metabolic disorders. Women with PCOS also have an increased cardiovascular risk because of dyslipidemia and insulin resistance. So far, we have a lot of information about the etiology of PCOS, and many steps forward have been made about the diagnosis of this syndrome, but there is still no certainty about the therapy. Myo-inositol (MI) and D-chiro-inositol, two inositol stereoisomers, have been proven to be effective in PCOS treatment. However, only MI has been shown to have beneficial effects on reproductive function, whereas the administration of MI/D-chiro-inositol, in the physiological plasma ratio (i.e., 40:1) ensures better clinical results, such as the reduction of insulin resistance, androgens’ blood levels, cardiovascular risk and regularization of menstrual cycle with spontaneous ovulation.

Keywords::

• infertility
• inositol
• insulin resistance
• oocyte
• polycystic ovarian syndrome

Financial & competing interests disclosure

V Unfer is the president of LO.LI. Pharma s.r.l. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Polycystic ovary syndrome is one of the most common endocrine disorders affecting women in reproductive age.

• Two inositol stereoisomers, myo-inositol (MI) and D-chiro-inositol (DCI), have been proven to be effective in polycystic ovary syndrome treatment.

• Both MI and DCI are able to exert an insulin-sensitizing effect, leading to a reduction of glucose and insulin levels in the blood.

• The activation of phospholipids containing MI by insulin increases the permeability of the cell membrane to glucose, while phospholipids containing DCI mediate glycogen synthesis.

• The MI and DCI levels are crucial for a proper tissue function, and polycystic ovary syndrome patients showed an altered MI/DCI ratio.

• The combined supplementation of MI and DCI, in a physiological range (40:1), may represent a therapeutic approach that is able to ensure better clinical results both at systemic and ovary levels.

Notes