If you’ve been trying to get pregnant for over a year and failing despite following all the rules, you are likely being affected by infertility. The World Health Organization estimates that infertility affects over 48 million couples and 186 million individuals worldwide, and globally, it is now officially recognized as a public health issue.
There are varying causes for infertility
According to the Cleveland Clinic, for 1 in 3 infertile women, there is a problem with the female reproductive system. For 1 in 3 infertile men, there is a problem with the male reproductive system. And finally, for 1 in 3 couples, there is a problem that affects them both that may or may not be undetermined.
In women, several factors can lead to female infertility. In addition to PCOS, thyroid disease, endometriosis, and uterine fibroids can a woman’s ability to become pregnant. Other conditions can also be influencers. These include celiac disease, blocked fallopian tubes, kidney disease, pelvic inflammatory disease, past ectopic pregnancy, disorders of the pituitary glands, and sickle cell anemia.
While research continues to find more scientific reasons for infertility, doctors have been seeing an uptick in both couples and individuals who seek treatment for infertility, many of whom are over the age of 35.
On the other hand, there are more and more options to counter the issue. One of the more promising treatments for infertility available today is known as inositol, a vitamin-like substance that has been showing very positive results.
Speaking to Very Well Health, Angela Grassi, MS, RDN, LDN, and the founder of the PCOS Nutrition Center, explains that the body can produce inositol, which functions as a kind of sugar that helps to balance certain chemicals in the body. These chemicals are responsible for managing blood sugar, metabolism, mood swings, and - you guessed it - fertility.
To increase your body’s natural levels of inositol’s, Dr. Grassi recommends women eat foods like grapefruit and other citrus fruits, navy and lima beans, in addition to brown rice, whole wheat, almonds, and walnuts. Be sure to consult your physician on possible contraindication/interactions with citrus fruits and current medications.
How inositol works to address causes of infertility
In treating infertility, there are two types of inositol that seem to have benefits. Myo- (MI) and d-chiro (DCI) have both been proven to be important when it comes to the body’s response to insulin. Hormones that are important for the production of eggs in the ovaries are also controlled by MI, while DCI assists in the controlling of male hormone levels in women.
While an estimated 99% of the inositol’s in the body are MI, researchers believe that women need a healthy balance with about 1% of DCI for optimal fertility. When the levels of DCI in the body are too low, there is a higher risk of insulin resistance and high blood sugar levels.
Research on inositol shows it can treat problems relating to infertility
In one study published in the Journal of Medicine (Baltimore), researchers found that myoinositol supplements were able to increase clinical pregnancy rates in infertile women who were undergoing ovulation induction for ICSI or IVF-ET. Not only that, but the study concluded that the supplementation might have the ability to improve the quality of embryos, while also reducing the unsuitable oocytes (follicles found in the outside layer of the ovaries) and the required amount of stimulation therapy which can include prescribed medication.
Women who have PCOS have responded particularly well to myo-inositol treatment. It is common for women with PCOS to be insulin resistant, which causes the body to be unable to use the insulin it makes effectively. Those who suffer from it are at higher risk for developing both diabetes and infertility, as well as obesity and high cholesterol levels.
Solutions to this problem can lie within the body’s messaging system when it comes to its response to insulin. According to the research, inositol can function as a backup messaging system in the case of a failure in the regular insulin signaling system.
Various studies have shown positive results when patients with PCOS and other infertility issues such as thyroid disease, fibroids, and endometriosis, were treated with inositol.
How does inositol help treat thyroid disease?
Clinical studies have found that following treatment with Myo-inositol plus selenomethionine (Myo-Ins + Se), thyroid-stimulating hormone (TSH) levels significantly declined in patients with subclinical hypothyroidism due to autoimmune thyroiditis.
How does inositol help to treat endometriosis?
An article published in the Journal of Reproductive Biology and Endocrinology found that when patients with poor ovarian response were supplemented with Myo-inositol, the assisted reproductive technique outcomes were significantly improved. Both fertilization rate gonadotropin and the ovarian sensitivity index were improved, while the required unities of gonadotropin - a fertility medication - were markedly reduced.
How does inositol help treat PCOS?
In a study published in Minerva Gynecology that involved over 130 people with PCOS and insulin resistance, those treated with myo-inositol were six times as likely to report regular menstrual cycles are those treated with the placebo. Furthermore, the study also treated the third group with d-chiro-inositol and was unable to find a difference between the two groups. When it comes to ovulation, a study found that 70% of those who were treated with Myo-inositol ovulated successfully, while only 21% of those in the placebo group did. The myo-inositol group further saw a significant decrease in their testosterone levels. Another 2016 study published in Gynecological Endocrinology put Myo-inositol and metformin - a drug used to lower blood glucose and insulin levels and is sometimes used to treat diabetes - head-to-head. The study delivered the same effects on menstrual cycle regularity for both treatments.
How does inositol help treat fibroids?
In a study published in MOJ Clinical & Medical Case Reports, inositol was shown to be one of the most proven supplements in the treatment of fibroids, as well as in the prevention of PCOS.
Inositol supplements also offer an effective alternative to metformin, which is very common in the treatment of the symptoms of diabetes and PCOS but does tend to have negative intestinal side effects in patients, such as abdominal discomfort, cramping, diarrhea, and nausea. Because inositol can help the body to better process sugar, it can also assist in normalizing ovarian function, while being an inexpensive option that doesn’t require a prescription, known to be well tolerated. Inositol can also be used in combination with metformin.
Boivin J., Bunting L., Collins JA., et al. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Human reproduction (Oxford, England) 2007;22(6):1506-12. doi: 10.1093/humrep/dem046 [published Online First: 2007/03/23]
D'anna R., Di Benedetto V., Rizzo P., Raffone E., Interdonato ML., Corrado F. Myo-inositol may prevent gestational diabetes in PCOS women. Gynecol Endocrinol. 2012;28(6):440-2. doi.org/10.3109/09513590.2011.633665
Grant G. Preventing polycystic ovary syndrome (PCOS) & uterine fibroids in women. MOJ Clin Med Case Rep. 2016;5(4):248. DOI: 10.15406/mojcr.2016.05.00139
Fallahi P, Ferrari SM, Elia G, Ragusa F, Paparo SR, Caruso C, Guglielmi G, Antonelli A. Myo-inositol in autoimmune thyroiditis, and hypothyroidism. Rev Endocr Metab Disord. 2018 Dec;19(4):349-354. doi: 10.1007/s11154-018-9477-9. PMID: 30506520.
Franca Fruzzetti, Daria Perini, Marinella Russo, Fiorella Bucci & Angiolo Gadducci (2017) Comparison of two insulin sensitizers, metformin and Myo-inositol, in women with polycystic ovary syndrome (PCOS), Gynecological Endocrinology, 33:1, 39-42, DOI: 10.1080/09513590.2016.1236078
Formuso C, Stracquadanio M, Ciotta L. Myo-inositol vs. D-chiro inositol in PCOS treatment. Minerva Ginecol. 2015 Aug;67(4):321-5. Epub 2015 Feb 11. PMID: 25670222.
Kalra B, Kalra S, Sharma JB. The inositols and polycystic ovary syndrome. Indian J Endocrinol Metab. 2016 Sep-Oct; 20(5): 720–724. doi:10.4103/2230-8210.189231
Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012;9(12):e1001356. doi: 10.1371/journal.pmed.1001356 [published Online First: 2012/12/29]
Mohammadi, S., Eini, F., Bazarganipour, F. et al. The effect of Myo-inositol on fertility rates in poor ovarian responder in women undergoing assisted reproductive technique: a randomized clinical trial. Reprod Biol Endocrinol 19, 61 (2021). https://doi.org/10.1186/s12958-021-00741-0
Rutstein SO, Shah IH. Infecundity infertility and childlessness in developing countries. Geneva: World Health Organization 2004.
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 (Baltimore). 2017;96(49):e8842. doi:10.1097/MD.0000000000008842