Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology

Costanzo Moretti¹, Marco Bonomi^{2

3}, Paola Dionese⁴, Silvia Federici^{2

3}, Anna Maria Fulghesu⁵, Jacopo Giannelli⁶, Roberta Giordano⁷, Laura Guccione¹, Elisa Maseroli⁸, Paolo Moghetti⁹, Roberto Mioni¹⁰, Rosario Pivonello¹¹, Chiara Sabbadin¹², Carla Scaroni¹², Massimo Tonacchera¹³, Nunzia Verde¹⁴, Linda Vignozzi⁸, Alessandra Gambineri¹⁵

Affiliations

¹ Department of Systems' Medicine, University of Rome Tor Vergata, Rome, Italy.
² Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
³ Department of Endocrine and Metabolic Diseases, IRCCS Instituto Auxologico Italiano, Milan, Italy.
⁴ Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy.
⁵ Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, Monserrato, Cagliari, Italy.
⁶ Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
⁷ Department of Biological and Clinical Sciences, University of Turin, Turin, Italy.
⁸ Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences, Mario Serio Careggi University Hospital, Florence, Italy.
⁹ Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy.
¹⁰ Department of Medicine, Clinica Medica 3-Azienda Ospedaliera, University of Padua, Padua, Italy.
¹¹ Dipartimento di Medicina Clinica e Chirurgica, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
¹² Endocrinology Unit, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy.
¹³ Department of Endocrinology, Pisa University Hospital of Cisanello, Azienda Ospedaliera Universitaria, Pisa, Italy.
¹⁴ Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione, Sessualità e Affermazione di Genere, Università Federico II di Napoli, Naples, Italy.
¹⁵ Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy. alessandra.gambiner3@unibo.it.

PMID: 39009925
DOI: 10.1007/s40618-024-02363-w

Review

Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology

Costanzo Moretti et al. J Endocrinol Invest. 2024 Sep.

. 2024 Sep;47(9):2111-2141.

doi: 10.1007/s40618-024-02363-w. Epub 2024 Jul 15.

Authors

Affiliations

¹ Department of Systems' Medicine, University of Rome Tor Vergata, Rome, Italy.
² Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
³ Department of Endocrine and Metabolic Diseases, IRCCS Instituto Auxologico Italiano, Milan, Italy.
⁴ Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy.
⁵ Department of Surgical Science, Duilio Casula Hospital, University of Cagliari, Monserrato, Cagliari, Italy.
⁶ Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
⁷ Department of Biological and Clinical Sciences, University of Turin, Turin, Italy.
⁸ Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental and Clinical Biomedical Sciences, Mario Serio Careggi University Hospital, Florence, Italy.
⁹ Unit of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Verona, Verona, Italy.
¹⁰ Department of Medicine, Clinica Medica 3-Azienda Ospedaliera, University of Padua, Padua, Italy.
¹¹ Dipartimento di Medicina Clinica e Chirurgica, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
¹² Endocrinology Unit, Department of Medicine (DIMED), University Hospital of Padua, Padua, Italy.
¹³ Department of Endocrinology, Pisa University Hospital of Cisanello, Azienda Ospedaliera Universitaria, Pisa, Italy.
¹⁴ Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Diabetologia, Andrologia e Nutrizione, Unità di Andrologia e Medicina della Riproduzione, Sessualità e Affermazione di Genere, Università Federico II di Napoli, Naples, Italy.
¹⁵ Division of Endocrinology and Diabetes Prevention and Care, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy. alessandra.gambiner3@unibo.it.

PMID: 39009925
DOI: 10.1007/s40618-024-02363-w

Abstract

Purpose: To provide the latest scientific knowledge on the efficacy of inositols for improving reproductive disorders in women with and without polycystic ovary syndrome (PCOS) and to reach a consensus on their potential use through a Delphi-like process.

Methods: A panel of 17 endocrinologists and 1 gynecologist discussed 4 key domains: menses irregularity and anovulation, fertility, pregnancy outcomes, and neonatal outcomes.

Results: A total of eight consensus statements were drafted. Myo-inositol (Myo) supplementation can be used to improve menses irregularities and anovulation in PCOS. Myo supplementation can be used in subfertile women with or without PCOS to reduce the dose of r-FSH for ovarian stimulation during IVF, but it should not be used to increase the clinical pregnancy rate or live birth rate. Myo supplementation can be used in the primary prevention of gestational diabetes mellitus (GDM), but should not be used to improve pregnancy outcomes in women with GDM. Myo can be preconceptionally added to folic acid in women with a previous neural tube defects (NTD)-complicated pregnancy to reduce the risk of NTDs in newborns. Myo can be used during pregnancy to reduce the risk of macrosomia and neonatal hypoglycemia in mothers at risk of GDM.

Conclusion: This consensus statement provides recommendations aimed at guiding healthcare practitioners in the use of inositols for the treatment or prevention of female reproductive disorders. More evidence-based data are needed to definitively establish the usefulness of Myo, the appropriate dosage, and to support the use of D-chiro-inositol (DCI) or a definitive Myo/DCI ratio.

Keywords: Delphi consensus; Fertility; Neonatal outcomes; Ovulation; Pregnancy outcomes.

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References

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Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology

Affiliations

Inositols and female reproduction disorders: a consensus statement from the working group of the Club of the Italian Society of Endocrinology (SIE)-Women's Endocrinology

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources

Medical