Myoinositol for treating infertile patients - a reality check

The most fashionable infertility medicine in India today seems to be myoinositol . It is being aggressively promoted in infertility conferences – and lots of “ infertility experts” are describing their clinical experiences with this drug.

PCOD patients were found to be deficient in myoinositol , and studies from Italy showed that treating PCO patients with myoinositol helped to improve their egg quality. It improved their insulin resistance , and some started ovulating after taking the myoinositol. It was easy to take, had few side effects, was inexpensive , and appealed to patients, because it was “natural”.  This is why myoinositol supplementation for patients with polycystic ovarian syndrome has become quite popular.  It does make sense to try this for PCOD patients , and I have no argument with this use.

However, the problem is that once pharma companies realize they have a new molecule for treating ovulatory disorders, they start promoting and pushing the drug for patients who do not have PCOD as well ! Lots of them have got on the bandwagon, and are manufacturing this molecule. Because they are so good at marketing, they sell this under a lot of clever brand names, such as Oosure.

This is a very clever name , because the message implicit in the name is that this supplement improves egg quality. Infertility specialists ( KOLs, or knowledge opinion leaders) are sponsored by these companies to present lectures at medical conferences, highlighting the utility of this molecule.

What is worrisome is that gynecologists start prescribing myoinositol for all their infertile patients with ovulatory dysfunction – even the ones who do not have PCOD ! After all, it’s very tempting to try the “newest medicine” available on all your patients ! Many IVF specialists now routinely prescribe it to everyone who is doing IVF, in the hope that this will help them produce better eggs. After all, it’s not really a drug , it is a natural supplement, so what’s the harm in giving it to everyone ? Even if it does not help, it’s not likely to cause any harm. It’s inexpensive, and easily available ( Indian companies are great at making copycat molecules very cheaply) and it’s so easy to write a prescription – especially for something which the patient has never taken before. The brand name is very seductive, and patients are suitably impressed that their doctor is uptodate and well-informed. Sadly, this kind of overuse and dilution of valid indications for prescribing myoinositol is not good medical practice – and the only beneficiary seems to be the pharmaceutical company .