d-Chiro-inositol and its significance in polycystic ovary syndrome: a systematic review

  title={d-Chiro-inositol and its significance in polycystic ovary syndrome: a systematic review},
  author={Nicolas Galazis and Myria Galazi and William Atiomo},
  journal={Gynecological Endocrinology},
  pages={256 - 262}
BACKGROUND The pathogenesis of polycystic ovary syndrome (PCOS) has been linked to the development of insulin resistance and hyperinsulinemia. [] Key MethodMETHODS This was a systematic review done in an Academic Department of Obstetrics and Gynaecology in the UK of all studies published on PCOS and DCI up till May 2010. Patients were women with PCOS receiving DCI or where the relationship between insulin resistance and DCI had been investigated.

Modulatory role of D-chiro-inositol (DCI) on LH and insulin secretion in obese PCOS patients

  • A. GenazzaniS. Santagni T. Simoncini
  • Medicine, Biology
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • 2014
DCI administration is effective in restoring better insulin sensitivity and an improved hormonal pattern in obese hyperinsulinemic PCOS patients, in particular, in hyper insulinemicPCOS patients who have diabetic relatives.

Differential insulin response to myo-inositol administration in obese polycystic ovary syndrome patients

  • A. GenazzaniA. Prati P. Artini
  • Medicine, Biology
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • 2012
The hypothesis that MYO administration is more effective in obese patients with high fasting insulin plasma levels is supported, as well as the efficacy on insulin sensitivity and hormonal parameters of 8 weeks treatment with myo-inositol.

The use of inositol(s) isomers in the management of polycystic ovary syndrome: a comprehensive review

  • A. GatevaV. UnferZ. Kamenov
  • Biology
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • 2018
Myo-inositol monotherapy results more effective in preventing and treating GDM even if a larger cohort of studies is needed to better clarify these results.

Inositols’ Importance in the Improvement of the Endocrine–Metabolic Profile in PCOS

The aim of this review is to present the effectiveness of MI and DCI treatment for PCOS symptoms, and is focused on analyzing the use of inositols, taking into account their physiological properties, together with the mechanism of individual PCOS symptom formation.

The menstrual cycle regularization following d-chiro-inositol treatment in PCOS women: a retrospective study

The use of d-chiro-inositol treatment is associated to clinical benefits for many women affected by PCOS including the improvement in insulin resistance and menstrual cycle regularity.


Objective: Ovary Syndrome (PCOS), based on Alternative Insulin Sensitizers as Inositol and α natural antioxidant, a Design: Setting: Patients: Intervention: Main outcome measures: therapeutic

Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

In PCOS treatment, MYO is observed more effective in reductions of total ovarian volume and AMH levels, and myo-ins effects on anti-Mullerian hormone levels and compare them with those obtained administering COC are examined.

Combining treatment with myo-inositol and D-chiro-inositol (40:1) is effective in restoring ovary function and metabolic balance in PCOS patients

New experimental and clinical evidence with MI plus DCI evidenced the suitability of such integrated approach, and provided promising results, further studies need to investigate thoroughly the molecular mechanism and confirm such preliminary data.

Myo-inositol administration positively effects ovulation induction and intrauterine insemination in patients with polycystic ovary syndrome: a prospective, controlled, randomized trial

This study shows that MYO should be considered in the treatment of infertile PCOS patients, as MYO administration increases clinical pregnancy rates, lowers total rFSH dose and the duration of the ovulation induction.

Myoinositol combined with alpha-lipoic acid may improve the clinical and endocrine features of polycystic ovary syndrome through an insulin-independent action

  • S. De CiccoV. Immediata R. Apa
  • Medicine, Biology
    Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
  • 2017
The combined treatment of ALA and MYO is able to restore the menstrual pattern and to improve the hormonal milieu of PCOS women, even in the absence of apparent changes in insulin metabolism.



Altered D-chiro-inositol urinary clearance in women with polycystic ovary syndrome.

UCl(DCI) is inversely correlated with insulin sensitivity in women and is a strong independent predictor of insulin resistance in multivariate models, consistent with a defect in tissue availability or utilization of DCI in PCOS that may contribute to the insulin resistance of the syndrome.

Ovulatory and metabolic effects of D-chiro-inositol in the polycystic ovary syndrome.

D-chiro-inositol increases the action of insulin in patients with the polycystic ovary syndrome, thereby improving ovulatory function and decreasing serum androgen concentrations, blood pressure, and plasma triglyceride concentrations.

Effects of d-chiro-inositol in lean women with the polycystic ovary syndrome.

  • M. J. IuornoD. Jakubowicz J. Nestler
  • Medicine
    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • 2002
It is concluded that, in lean women with the polycystic ovary syndrome, D-chiro-inositol reduces circulating insulin, decreases serum androgens, and ameliorates some of the metabolic abnormalities ( increased blood pressure and hypertriglyceridemia) of syndrome X.

Insulin-lowering agents in the management of polycystic ovary syndrome.

In a high percentage of patients, treatment with metformin is followed by regularization of menstrual cycle, reduction in hyperandrogenism and in cardiovascular risk factors, and improvement in response to therapies for induction of ovulation.

The use of metformin in the management of polycystic ovary syndrome and associated anovulatory infertility: The current evidence

  • L. LeemanU. Acharya
  • Medicine, Biology
    Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
  • 2009
An overview of PCOS is provided, relevant literature regarding metformin and PCOS related infertility is reviewed, and patient selection prior to instigating treatment is discussed.

Greek hyperinsulinemic women, with or without polycystic ovary syndrome, display altered inositols metabolism.

Greek women, with or without PCOS, display increased uCl (DCI) and decreased AUC(DCI-IPG) in association with higher insulin levels but independent of adiposity, which could contribute to insulin resistance and compensatory hyperinsulinemia in Greek women.

Metformin therapy increases insulin-stimulated release of D-chiro-inositol-containing inositolphosphoglycan mediator in women with polycystic ovary syndrome.

In obese women with PCOS, metformin may improve the action of insulin in part by improving insulin-mediated release of DCI-IPG mediators, as evidenced by increased bioactive DCI/AUC released per unit of insulin.

Lean women with polycystic ovary syndrome respond to insulin reduction with decreases in ovarian P450c17 alpha activity and serum androgens.

It is suggested that hyperinsulinemia stimulates ovarian P450c17 alpha activity in nonobese women with PCOS and decreasing serum insulin with metformin reduces ovarian cytochrome P 450c17alpha activity and ameliorates the hyperandrogenism of these women.

Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility.

The role of metformin in improving reproductive outcomes in women with PCOS appears to be limited, and there was no evidence that met formin improves live birth rates whether it is used alone or in combination with clomiphene, or when compared with clmiphene.

Role of hyperinsulinemia in the pathogenesis of the polycystic ovary syndrome, and its clinical implications.

  • J. Nestler
  • Medicine, Biology
    Seminars in reproductive endocrinology
  • 1997
Evidence indicating that insulin contributes to the hyperandrogenism of PCOS by stimulating ovarian androgen production and decreasing serum sex hormone-binding globulin (SHBG) concentrations is reviewed.