Science Update

Inositol supplementation improves pregnancy rate according to recent review

According to a recent review published this month in Medicine, researchers demonstrated that myo-inositol supplementation can increase pregnancy rate by increasing oocyte and embryo quality during an in vitro fertilization (IVF) program.

Inositol acts as second messenger which regulates several hormones such as follicle stimulating hormone (FSH), thyroid stimulating hormone, and insulin.

Previous studies have shown that an inositol deficiency is common in individuals with insulin resistance and PCOS. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods, which is a distinctive characteristic feature of insulin resistance. As a result, the nutritional requirements of these patients may not be met by a simple change in the diet, and inositol should be considered a conditionally essential nutrient in these women.

Although inositol is an insulin sensitizing agent commonly used for those with PCOS and insulin resistance, it also has some roles in reestablishing menstrual regularity and ovulation.

This review consisted of 7 studies including 935 women. The average dose of myo-inositol was 4 grams/day over a 3 month period before and during controlled ovulation induction. Myo-inositol supplementation was associated with a significantly improved pregnancy rate in infertile women undergoing an IVF program.

Since inositol plays a role in the regulation of FSH, it is critical for FSH signaling, oocyte maturation, and embryo development. Oocyte and embryo quality are considered to be the main challenge of IVF in assisted reproduction. Inositol is safe, inexpensive, and can have a therapeutic approach for women with fertility issues.

It is important to note that the conversion of myo-inositol to D-chiro-inositol is impaired in individuals with PCOS and insulin resistance, so supplementation in these individuals should take the form of both D-chiro-inositol and myo-inositol.

Also, one must keep in mind that exposure to endocrine-disrupting chemicals (EDCs) including bisphenol A (BPA), phthalates, PCBs, PBBs, PBDEs, pesticides, and heavy metals may also contribute to infertility. It is important to minimize further exposure by eating organic produce, drinking filtered water, using household products that are fragrance-free and free of phthalates and BPA, and replacing non-stick pans with glass, ceramic, or cast iron. Nutrients that support detoxification pathways include n-acetyl-cysteine, glutathione, calcium D-glucarate, milk thistle, and sulforaphane.

 

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Zheng X, Lin D, Zhang Y, et al. Inositol supplement improves clinical pregnancy rate in infertile women undergoing ovulation induction for ICSI or IVF-ET. Medicine, 2017 Dec;96(49):e8842. doi: 10.1097/MD.0000000000008842.