EFFICACY OF INOSITOLS IN POLYCYSTIC OVARY SYNDROME AND GESTATIONAL DIABETES MELLITUS: ANALYSIS OF PATHOGENETIC AND CLINICAL DATA

Infertility is a common problem in the world, which has a significant negative social impact. An important factor that affects female reproductive function is insulin resistance which is common for such conditions as polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM). PCOS is caused by hormone imbalance leading to high levels of male hormones (androgens). Androgen excess has a number of physical manifestations and leads to fertility problems. GDM occurs in pregnant women, it is characterised by the development of spontaneous hyperglycaemia, which is a serious pregnancy complication. Currently, there are various approaches to addressing the causes of infertility, but there have not been any significant improvements in birth rates. Therefore, alternative pharmacotherapeutic options are being explored to improve health and fertility, which include the use of various natural substances and dietary supplements. One such promising compound is inositol, due to its potential benefits in reproductive therapy. Its main bioactive forms in living organisms are myo-inositol and D-chiro-inositol whose insulin-sensitising and anti-androgenic effects help to ameliorate metabolic dysfunctions and fertility problems in PCOS. Inositol has the ability to improve endocrine profile, restore ovulation, improve oocyte and sperm quality, reduce the risk of ovarian hyperstimulation syndrome during the use of assisted reproductive technologies, thereby increasing the chances of pregnancy. The present review of studies supports the efficacy of inositol, but further research and clinical trials are needed to generate more reliable evidence and get a better understanding of inositol mechanism of action. An analysis was conducted of the results of fundamental and clinical studies on the use of MI for the treatment of diabetes mellitus, GDM, as well as in PCOS and reduced fertility, published in the databases Google Scholar, PubMed, Embase, Cochrane Library, CyberLeninka, and eLIBRARY.RU from 2015 to 2024. Earlier publications were also included in the narrative review. The search was performed using the keywords “inositol”, “myo-inositol”, “diabetes mellitus”, “gestational diabetes”, “polycystic ovary syndrome”, “hyperandrogenism”, and “spermatogenesis”. Keywords: Myo-inositol, D-chiro-inositol, fertility, gestational diabetes mellitus, polycystic ovary syndrome, insulin resistance, infertility.