Zhang, J., Zhang, H., Zhou, W., Jiang, M., & Lin, X. (2025). Effect of myo-inositol supplementation in mixed ovarian response IVF cohort: a systematic review and meta-analysis. Frontiers in endocrinology. https://doi.org/10.3389/fendo.2025.1520362
Zhang J, Zhang H, Zhou W, Jiang M, Lin X. Effect of myo-inositol supplementation in mixed ovarian response IVF cohort: a systematic review and meta-analysis. Frontiers in endocrinology. 2025. doi:10.3389/fendo.2025.1520362
Zhang, Jianeng, et al. "Effect of myo-inositol supplementation in mixed ovarian response IVF cohort: a systematic review and meta-analysis." Frontiers in endocrinology, 2025.
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RRM Academy Synopsis
Myo-inositol raised egg maturity and fertilization rates in IVF cycles
A 2025 meta-analysis of 11 studies and 981 women having IVF found that women taking myo-inositol had higher rates of mature eggs and fertilization. Mature egg rates were higher in women with PCOS (PMOS, Polyendocrine Metabolic Ovarian Syndrome) but not in poor ovary responders. Clinical pregnancy rates, from four studies, did not differ significantly.
Key Findings
Across ten studies, the metaphase II (MII) oocyte rate was higher with myo-inositol than in control groups (OR 1.55, 95% CI 1.04-2.31, P=0.03).
In women with PCOS the MII oocyte rate was higher (OR 1.97, 95% CI 1.20-3.25). In poor ovary responders it was not (OR 0.97, 95% CI 0.35-2.68, P=0.95).
Across nine studies, the fertilization rate was higher (OR 1.62, 95% CI 1.21-2.16, P<0.01), including women with PCOS (OR 1.59, 95% CI 1.16-2.18) and poor responders (OR 2.42, 95% CI 1.48-3.95).
Oocytes retrieved did not differ significantly (MD 0.22, 95% CI -0.43-0.88, P = 0.5). Clinical pregnancy rate, from four studies, did not differ significantly either (OR 1.53, 95% CI 0.93-2.53, P=0.09).
Interpretation
The paper is a systematic review and meta-analysis that pooled randomized trials with controlled observational studies. Results varied widely between studies (I2 = 91% for MII oocyte rate). Women with PCOS and poor ovary responders made up much of the sample. The authors note that the majority of studies reported no adverse events data. In non-obese women with PCOS, the MII result lost statistical significance when either of two studies was removed. Most outcomes are laboratory steps, and clinical pregnancy did not differ significantly. The authors call for larger randomized trials.
RRM Context
The paper calls myo-inositol an insulin sensitizer used in PCOS, where insulin resistance is common. IVF goes around the reproductive system and does not find why conception fails. These outcomes are steps inside that process. Restorative reproductive medicine asks why eggs mature poorly or ovulation falters, and evaluates both partners.
Our editorial summary of this paper, not the article's abstract.
Abstract
Objective
There has been substantial research conducted recently on the effect of myo-inositol (MI) on human reproduction. However, it still remains ambiguous about the therapeutic efficacy of MI in infertile women undergoing in vitro fertilization embryo transfer (IVF-ET). This systematic review and meta-analysis was carried out to investigate the efficacy of MI on IVF outcomes.
Methods
Literatures were searched in the PubMed, Web of Science, Cochrane Library, ScienceDirect and Wanfang databases. The methodological quality was assessed using the Cochrane Risk of Bias tool. Data were pooled using a random- or fixed-effects model according to study heterogeneity. The results are expressed as odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CIs). Heterogeneity was measured by the I2 statistic. The protocol was prospectively registered with PROSPERO (CRD42024582149).
Results
Eleven eligible studies with 981 participants reported the IVF outcomes of the MI group versus the control group. The synthesis results showed that the metaphase II (MII) oocyte rate was higher in the MI group than in the control group (OR 1.55, 95% CI 1.04-2.31, P=0.03). For polycystic ovary syndrome (PCOS) women, as well as non-obese PCOS women, a statistically significant improvement in MII oocyte rate were assumed after taking MI (OR 1.97, 95% CI 1.20-3.25, P<0.01; OR 1.92, 95% CI 1.09-3.37, P=0.02) while there is no statistically significant advancement showed in the poor ovary responder (POR) women(OR 0.97, 95% CI 0.35-2.68, P=0.95). The fertilization rate was higher in the MI group than in the control group (OR 1.62, 95% CI 1.21-2.16, P<0.01), for PCOS, non-obese PCOS and POR women (OR 1.59, 95% CI 1.16-2.18, P<0.01; OR 1.87, 95% CI 1.52-2.31, P<0.01; OR 2.42, 95% CI 1.48-3.95, P<0.01).
Conclusions
Our results suggest that MI supplementation improves the MII oocyte rate and the fertilization rate. More high-grade evidence from prospective randomized studies is warranted.
