Myo-Inositol Fertility Benefits:

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Dr. Norbert Gleicher

Does Myo-Inositol Improve Egg Quality & IVF Success Rates?

What is myo-inositol?

Myo-inositol is often used to improve egg quality in IVF, but only _some _infertility patients reap the myo-inositol egg quality benefits.

Myo-inositolused to be considered a vitamin within the vitamin B family but no longer has this designation. It is increasingly prescribed within the fertility field under the claim that it improves egg and embryo quality and, therefore, pregnancy rates in IVF. It is a so-called second messenger in signal transduction pathways and has been reported to be involved in the secretion of hormones by ovaries and some other endocrine glands. Its alleged effects have been especially highlighted in women with polycystic ovary syndrome (PCOS), where it is considered an insulin sensitizer, like metformin. Some studies have suggested that it reestablishes ovulation in a high percentage of anovulatory PCOS patients. At least one report in the literature suggests that supplementation with myo-inositol reduces the risk of gestational diabetes in pregnancy.

How is myo-inositol used in IVF cycles?

In female infertility, it has been suggested to reduce the amount of gonadotropin required for ovarian stimulation, improves egg numbers and quality and that high levels in amniotic fluid are associated with improved follicle stimulating hormone (FSH) signaling, oocyte maturation and embryo development.

Up to a dosage of 12 grams daily, myo-inositol appears to be well tolerated without significant side-effects, though nausea, fatigue, dizziness and insomnia have been reported. The most widely used dosage is 2 grams of myo-inositol in a 40:1 mixture with D-chiro-inositol in combination with 400 micrograms of folic acid twice a day. When supplementation should be initiated in association with IVF is unclear; but most reported studies initiated treatment 1-3 months before cycle start.

How does myo-inositol work?

Myo-inositol reduces androgen (male hormone levels). In hyper-androgenic PCOS patients, that may represent a significant benefit. In many other women with infertility, such as women with premature ovarian aging (POA, also called occult primary ovarian insufficiencyor oPOI) or in women with hypo-androgenic PCOS (H-PCOS), both conditions where women actually have abnormally low androgen levels, this hypo-androgenism may be exacerbated by myo-inositol supplementation.

CHR, therefore, does not recommend automatic myo-inositol supplementation since it may counteract androgen supplementation in women with POA/oPOI and H-PCOS, which at CHR is routine since ovaries must have normal testosterone levels within the ovarian micro-environment in order to produce good quality eggs at maximum numbers.

Who reaps myo-inositol fertility benefits?

In selected infertile women, especially in women with so-called classical PCOS phenotype, who demonstrate abnormally high testosterone levels in their blood, using myo-inositol supplements for fertility and pregnancy, therefore, appears indicated. CHR advises against routine supplementation in all infertile women, as the nutritional supplement industry, unfortunately, recommends without basis.

This is a part of the March 2019 CHR VOICE.

I discovered your clinic when I was at my lowest. I happened on a video on your you tube channel titled, "The burning out pcos." Just that video gave me much needed hope and direction because I couldn't get a diagnosis of why I was cold, lethargic and weak. I decided to become a patient for my fertility problems and fortunately I could consult online. Extending help internationally is really helpful. It is not easy to find this calibre, everywhere. I was 43 when I told Dr Gleicher I couldn't afford to travel there to do my IVF. He made sure he gave me some nuggets of wisdom to go with. For one, he insisted that my numbers showed I could have a child using my own eggs, like I wanted. The one clinic in my country doubted I could have a child in my late 30s. Another clinic in another country in the region would not even consult with me because I was 43 and not willing to use donor eggs. Another was willing to take me on but we had 2 failed IVF cycles. They also recommended donor eggs. I'm happy to share that I conceived naturally at 45 and I am looking at a perfectly healthy 5 month old baby boy. May the good Lord bless you and your work. You are truly doing the work of God. I could withstand the pressure to take donor eggs because you were very clear that my desire was possible. Congratulations and best wishes!

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I have been blessed to find CHR on my journey. If anyone is lucky to find the clinic they will be surrounded not only by the greatest medical knowledge and research when it comes to IVF but a group of amazing professional.Everyone I have met there is just genuinely kind, professional and so helpful. I cannot say enough great things about CHR and the only way to know what I'm talking about is to give them a chance. Thank you CHR

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