{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:23:29Z","timestamp":1787243009916,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,5,20]],"date-time":"2019-05-20T00:00:00Z","timestamp":1558310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      High levels of anti\u2010Mullerian hormone and a high antral follicle count in women with polycystic ovary syndrome, reflecting increased ovarian antral follicles, predisposes them to have a high number of retrieved oocytes with in vitro fertilization (\n                      <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>\n                      )\/intracytoplasmic sperm injection (\n                      <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>\n                      ) and an increased risk of ovarian hyperstimulation syndrome. Inositols, which act as insulin sensitizers, have the potential to alter folliculogenesis and the functional ovarian reserve, with subsequent benefits to reproductive outcomes following\n                      <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>\n                      treatment. Published literature is, however, unable to provide definitive evidence of its efficacy. The objective of our review was to evaluate the effect of inositols on anti\u2010Mullerian hormone, antral follicle count and reproductive outcomes in women with polycystic ovary syndrome undergoing\n                      <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>We performed a literature search using standard methodology recommended by Cochrane. Randomized controlled trials and non\u2010randomized studies comparing inositols with no treatment, placebo or other treatment were included in the review. Using standard methodology recommended by Cochrane we pooled results using the random effects model; our findings were reported as relative risk or mean differences. PROSPERO registration: CRD42017082275.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 18 trials. The primary outcome was a change in anti\u2010Mullerian hormone and antral follicle count before and after treatment, for which data were unsuitable for meta\u2010analysis. A narrative review showed no consistent direction or size of effect. A meta\u2010analysis for the secondary outcomes showed no evidence of a significant difference between inositol and control groups for any outcome: number of oocytes (mean difference \u22120.39, 95%\n                      <jats:styled-content style=\"fixed-case\">confidence interval [CI]<\/jats:styled-content>\n                      \u22121.11 to 0.33), number of metaphase\n                      <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>\n                      oocytes (mean difference 0.29, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u22120.83 to 1.40), number of top grade embryos (risk ratio [\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      ] 1.02, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.93\u20101.12), clinical pregnancy rate (\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      1.16, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.87\u20101.53), and risk of ovarian hyperstimulation syndrome (\n                      <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>\n                      0.73, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.39\u20101.37). The quality of evidence was assessed as very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      There is insufficient evidence for an effect of inositols on ovarian reserve markers and to support their use as pretreatment before\n                      <jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">ICSI<\/jats:styled-content>\n                      in women with polycystic ovary syndrome.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.13625","type":"journal-article","created":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T00:10:12Z","timestamp":1555459812000},"page":"1235-1244","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["The effect of myo\u2010inositol\/di\u2010chiro\u2010inositol on markers of ovarian reserve in women with\n                    <scp>PCOS<\/scp>\n                    undergoing\n                    <scp>IVF<\/scp>\n                    \/\n                    <scp>ICSI<\/scp>\n                    : A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0871-6508","authenticated-orcid":false,"given":"Priya","family":"Bhide","sequence":"first","affiliation":[{"name":"Women\u2032s Health and Perinatology Research Group Department of Clinical Medicine UiT \u2013 The Arctic University of Norway Troms\u00f8 Norway"},{"name":"Homerton Fertility Center Homerton University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna","family":"Pundir","sequence":"additional","affiliation":[{"name":"Center for Reproductive Medicine St Bartholomew's Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Gudi","sequence":"additional","affiliation":[{"name":"Homerton Fertility Center Homerton University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Shah","sequence":"additional","affiliation":[{"name":"Homerton Fertility Center Homerton University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Homburg","sequence":"additional","affiliation":[{"name":"Homerton Fertility Center Homerton University Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1997-3107","authenticated-orcid":false,"given":"Ganesh","family":"Acharya","sequence":"additional","affiliation":[{"name":"Women\u2032s Health and Perinatology Research Group Department of Clinical Medicine UiT \u2013 The Arctic University of Norway Troms\u00f8 Norway"},{"name":"Division of Obstetrics and Gynecology Department of Clinical Science, Intervention and Technology Karolinska Institutet and Center for Fetal Medicine Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a2968"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-030727"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14410-8"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/des463"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1849162"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.83.6.2001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199904293401703"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.02.06.dc05-1070"},{"issue":"5","key":"e_1_2_9_10_1","first-page":"347","article-title":"Randomized, double blind placebo\u2010controlled trial: effects of myo\u2010inositol on ovarian function and metabolic factors in women with PCOS","volume":"11","author":"Gerli S","year":"2007","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590701672405"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.01.088"},{"issue":"4","key":"e_1_2_9_13_1","first-page":"452","article-title":"Myo\u2010inositol rather than D\u2010chiro\u2010inositol is able to improve oocyte quality in intracytoplasmic sperm injection cycles. A prospective, controlled, randomized trial","volume":"15","author":"Unfer V","year":"2011","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14754"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2017.1421632"},{"key":"e_1_2_9_16_1","first-page":"CD003053","article-title":"Insulin\u2010sensitising drugs (metformin, rosiglitazone, pioglitazone, D\u2010chiro\u2010inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility","volume":"11","author":"Morley LC","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2015.1014784"},{"issue":"5","key":"e_1_2_9_18_1","first-page":"509","article-title":"Effects of myo\u2010inositol supplementation on oocyte's quality in PCOS patients: a double blind trial","volume":"15","author":"Ciotta L","year":"2011","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-013-2855-3"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-2215-5-14"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4378507"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/3206872"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2015.1101444"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/1473612"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13304"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/6273298"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2017.07.005"},{"key":"e_1_2_9_28_1","unstructured":"HigginsJ GreenS (eds).Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011. Available fromhttp:\/\/handbook.cochrane.org"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reprotox.2015.10.014"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2017.1313972"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2014.964201"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1159\/000375530"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2012.743020"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-014-0307-z"},{"issue":"1","key":"e_1_2_9_35_1","first-page":"38","article-title":"Inositol supplementation and IVF outcome: preliminary data","volume":"24","author":"Schillaci R","year":"2012","journal-title":"It J Gyn\u00e6col Obstet"},{"key":"e_1_2_9_36_1","first-page":"CD012378","article-title":"Inositol for subfertile women with polycystic ovary syndrome","volume":"12","author":"Showell MG","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.18.6.774"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13625","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.13625","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.13625","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T22:37:07Z","timestamp":1694299027000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.13625"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,20]]},"references-count":36,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10]]}},"alternative-id":["10.1111\/aogs.13625"],"URL":"https:\/\/doi.org\/10.1111\/aogs.13625","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,20]]},"assertion":[{"value":"2019-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-05-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}