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Studies involving myo-inositol as a preventive treatment against NTDs in women with a previous pregnancy affected by NTD despite folate supplementation. Study Kamenov Z, Kolarov G, Gateva A, Carlomagno G, Genazzani AD. Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance. Gynecol Endocrinol 2015;31(2):131-5. View abstract.Pregnancy rate after the first treatment: 26.1% in the metformin group versus 28.9% in the myo-inositol group Kukuljan, M.; Vergara, L.; Stojilković, S. S. (February 1997). "Modulation of the kinetics of inositol 1,4,5-trisphosphate-induced [Ca 2+]i oscillations by calcium entry in pituitary gonadotrophs". Biophysical Journal. 72 (2 Pt 1): 698–707. Bibcode: 1997BpJ....72..698K. doi: 10.1016/S0006-3495(97)78706-X. PMC 1185595. PMID 9017197. Monastra, G.; Unfer, V.; Harrath, A. H.; Bizzarri, M. (January 2017). "Combining treatment with myo-inositol and D- chiro-inositol (40:1) is effective in restoring ovary function and metabolic balance in PCOS patients". Gynecological Endocrinology. 33 (1): 1–9. doi: 10.1080/09513590.2016.1247797. hdl: 11573/944617. PMID 27898267. S2CID 24836559. D- chiro-inositol is an important messenger molecule in insulin signaling. [31] Inositol supplementation has been shown to significantly decrease triglycerides and LDL cholesterol in patients with metabolic diseases. [31] Gregersen G, Borsting H, Theil P, Servo C. Myoinositol and function of peripheral nerves in human diabetics. A controlled clinical trial. Acta Neurol Scand 1978;58:241-8. View abstract.

A type of inositol, D-chiro-inositol, combined with folic acid also increased insulin sensitivity in people with type 1 diabetes. People treated with inositol and folic acid had lower average blood sugar levels, known as HbA1c, than the people in the control group. Insulin resistance occurs when the body’s tissues are resistant to the effects of insulin. This means that the cells don’t allow glucose to enter. In PCOS, insulin resistance occurs because the higher androgen levels reduce sensitivity to insulin in the body. Vitale SG, Corrado F, Caruso S, et al. Myo-inositol supplementation to prevent gestational diabetes in overweight non-obese women: bioelectrical impedance analysis, metabolic aspects, obstetric and neonatal outcomes - a randomized and open-label, placebo-controlled clinical trial. Int J Food Sci Nutr. 2020:1-10. View abstract.Hallman M, et al. Inositol supplementation in premature infants with respiratory distress syndrome. N Engl J Med 1992;326:1233-9. View abstract. Vitagliano, A.; Saccone, G.; Cosmi, E.; Visentin, S.; Dessole, F.; Ambrosini, G.; Berghella, V. Inositol for the prevention of gestational diabetes: A systematic review and meta-analysis of randomized controlled trials. Arch. Gynecol. Obs. 2019, 299, 55–68. [ Google Scholar] [ CrossRef] Owczarczyk-Saczonek A, Czerwinska J, Wygonowska E, Kasprowicz-Furmanczyk M, Placek W. D-chiro-inositol as a treatment in plaque psoriasis: A randomized placebo-controlled clinical trial. Dermatol Ther. 2021;34(1):e14538. View abstract. Nordio M, Proietti E. The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. Eur Rev Med Pharmacol Sci 2012;16(5):575-81. View abstract.

Du Y, He Y, Wang YL, Zhou JG, Chen C. The efficacy and safety of inositol supplementation in preterm infants to prevent retinopathy of prematurity: a systematic review and meta-analysis. BMC Ophthalmol 2019;19(1):135. View abstract. Facchinetti, F.; etal. (2015). "Results from the International Consensus Conference on myo-Inositol and D- chiro-Inositol in Obstetrics and Gynecology: the link between metabolic syndrome and PCOS". European Journal of Obstetrics & Gynecology and Reproductive Biology. 195: 72–6. doi: 10.1016/j.ejogrb.2015.09.024. PMID 26479434. The use of inositols in PCOS is gaining more importance, and an efficacy higher than 70% with a strong safety profile is reported. On the other hand, about 30% of patients could show as inositol-resistant. [45] New evidence regarding PCOS aetiopathogenesis describes an alteration in the species and the quantity of each strain characterizing the normal gastrointestinal flora. This alteration could lead to chronic, low-level inflammation and malabsorption. [46] A possible solution could be represented by the combination of myo-inositol and α-lactalbumin. This combination shows a synergic effect in increasing myo-inositol absorption. [47] A recent study reported that the myo-inositol and α-lactalbumin combination is able to increase myo-inositol plasmatic content in inositol-resistant patients with a relative improvement of hormonal and metabolic parameters. [48]

Open-label treatment with 1000 mg per day from at least two months before and until 60 days after conception Fleming, I.N.; Batty, I.H.; Prescott, A.R.; Gray, A.; Kular, G.S.; Stewart, H.; Downes, C.P. Inositol phospholipids regulate the guanine-nucleotide-exchange factor Tiam1 by facilitating its binding to the plasma membrane and regulating GDP/GTP exchange on Rac1. Biochem. J. 2004, 382, 857–865. [ Google Scholar] [ CrossRef] [ PubMed] Summary of the studies involving myo-inositol as a treatment for ovulation induction, regularization of menstrual cycle or in the pursuit of pregnancy. Study

Groenen, P.M.; Peer, P.G.; Wevers, R.A.; Swinkels, D.W.; Franke, B.; Mariman, E.C.; Steegers-Theunissen, R.P. Maternal myo-inositol, glucose, and zinc status is associated with the risk of offspring with spina bifida. Am. J. Obs. Gynecol. 2003, 189, 1713–1719. [ Google Scholar] [ CrossRef] Inositol, phosphatidylinositol and some of their mono- and polyphosphates function as secondary messengers in a number of intracellular signal transduction pathways. They are involved in a number of biological processes, including: Phelps DL, Ward RM, Williams RL, et al. Pharmacokinetics and safety of a single intravenous dose of myo-inositol in preterm infants of 23-29 wk. Pediatr Res 2013;74(6):721-9. View abstract. Phelps DL, Watterberg KL, Nolen TL, et al. Effects of Myo-inositol on Type 1 Retinopathy of Prematurity Among Preterm Infants <28 Weeks' Gestational Age: A Randomized Clinical Trial. JAMA. 2018;320(16):1649-1658. View abstract. Shaltiel G, Shamir A, Shapiro J, et al. Valproate decreases inositol biosynthesis. Biol Psychiatry 2004;56:868-74. View abstract.Majumder, A. L.; Biswas, B. B. (2006-10-03). Biology of Inositols and Phosphoinositides. Springer Science & Business Media. ISBN 9780387276007. Myo-inositol was considered a member of the B-vitamin complex and was known as B8 despite not being an essential nutrient, as it can be produced by the body from glucose. As myo-inositol is an FSH second messenger, it is effective in restoring an optimal FSH/LH ratio and regulating the menstrual cycle. This link to FSH can also lead to improved ovarian follicle maturation and higher oocyte quality – potentially increasing reproductive success. Nomenclature of Cyclitols. IUPAC Commission on the Nomenclature of Organic Chemistry (CNOC) and IUPAC-IUB Commission on Biochemical Nomenclature (CBN). Available at: https://www.chem.qmw.ac.uk/iupac/cyclitol/ (Accessed 23 January 2004).