The effect of myo-inositol on assisted reproductive technology outcomes in women with polycystic ovarian syndrome: A systematic review and meta-analysis of randomized clinical trial studies

Background: Conflicting evidence from clinical trials on the effects of myo-inositol and D-chiro-inositol on assisted reproductive technology (ART) outcomes in women with polycystic ovarian syndrome (PCOS) necessitates a systematic review and meta-analysis. Objective: To evaluate the effect of myo-inositol and D-chiro-inositol on ART outcomes in women with PCOS. Materials and Methods: A comprehensive search was conducted in PubMed, Scopus, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Library for studies published from January 2000–2023. Statistical analyses were performed using STATA version 17. Results: 17 intervention studies were included. myo-inositol/D-chiro-inositol supplementation significantly increased the clinical pregnancy rate (RR: 1.64, 95% CI: 1.25–2.15; I2 = 13.5%; p = 0.32) and top-grade embryos (RR: 1.12, 95% CI: 1.02–1.23; I2 = 85.43%; p = 0.0001). However, it was associated with reductions in antral follicle count (WMD: -0.78, 95% CI: -1.07 to -0.49; I2 = 97.37%; p = 0.001) and anti-Mullerian hormone levels (WMD: -0.46, 95% CI: -0.67 to -0.25; I2 = 91.95%; p = 0.001). Conclusion: This meta-analysis provides reliable evidence on the effects of myo-inositol/D-chiro-inositol on fertility and ovarian function in women with PCOS undergoing ART.