Репродуктивная эндокринология (Dec 2020)
Inositols in reproductive medicine
Abstract
The article presents literature data on the role of inositol and its derivatives in human body, results of the myo-inositol (MI) use in gynecological diseases, treatment of female and male infertility, including in cycles of assisted reproductive technologies, in the prevention of gestational and perinatal complications. It has been shown that the inability to adequately synthesize or metabolize inositol can contribute to disturbances in the transmission of intracellular signals, disturbances in the activity of insulin signaling cascades, development of insulin resistance and hyperinsulinemia, which cause abnormal steroidogenesis in the gonads and metabolic disorders. The concept of “D-chiro-inositol paradox” is highlighted, according to which women with polycystic ovary syndrome are characterized by increased epimerization of MI to D-chiro-inositol, depletion of MI reserves and low oocyte quality. Prescribing biologically active supplements with MI and folic acid for pregnant women reduces the likelihood of threatened abortion, preeclampsia, placental dysfunction, gestational diabetes mellitus, diabetic fetopathy, malformations, oxidative stress in the fetus. Experience has also been accumulated about myo-inositol use in andrology: it plays a decisive role in osmoregulation of seminal fluid and, as a consequence, increasing the progressive sperm motility and speed, increasing the mitochondrial sperm potential, improves libido and potency, helps to increase the endogenous testosterone, and normalizes the men’s hormonal balance. Inositol is a synergist of folates and other B vitamins and significantly potentiates their effect on the human body; it is the basis for the advantages of using combined biological supplements such as Miofolic® and Miofolic® MEN in the clinic for female and male reproduction. Harmonious use of all possible reserves of micronutrient support for the preconception and gestational period with the use of biologically active supplements of MI in combination with folic acid and vitamin B12 is a promising preventive and therapeutic agent in supporting of reproductive system, embryo development, neuroprotection of the fetal brain, ensuring the activity of signaling cascades insulin.
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