A quick heads-up to women taking DHEA to support egg quality: Check other supplements in your routine for myo-inositol. According to Dr. Norbert Gleicher, Medical Director at the Center for Human Reproduction, who led many of the early studies on the use of DHEA to support female reproductive health, myo-inositol is one of the most common supplements he sees his IVF patients taking, along with DHEA. Taking DHEA with myo-inositol, however, is counterproductive, says Dr. Gleicher. Read on to see why - it has to do with our individuality, and how the two function in the body.

What is myo-inositol?

Let’s start with the basics. Myo-inositol is a type of sugar – a sugar alcohol – in the inositol family. Our bodies, mainly the kidneys, synthesize myo-inositol from glucose, and store it mostly in the brain and liver. Some foods also contain inositols – including fruits, beans, nuts and grains.

What does myo-inositol do in the body?

Myo-inositol forms the structural basis for many secondary messengers. (Secondary messengers are molecules in our cells that trigger physiological changes in response to signals from outside the cells – like hormones and neurotransmitters.) As such, scientists believe, myo-inositol plays multiple fundamental roles in our bodies:

• Mood regulation: Myo-inositol influences the balance of neurotransmitters, like serotonin and dopamine, that affect mood.
• Blood sugar regulation: According to some clinical studies, myo-inositol may impact how insulin functions, which may help maintain healthy blood sugar levels – including during pregnancy.
• Metabolic health: Several studies have suggested that myo-inositol may help support metabolic health through maintenance of normal levels of triglycerides, cholesterol and blood pressure.

Why is myo-inositol popular in preconception supplements?

Some studies, including prospectively randomized trials like this one, have suggested that myo-inositol may play a role in maintenance of normal ovulation. Other studies, like this randomized trial of 60 women undergoing IVF, have also suggested that myo-inositol may support egg and embryo quality.

Combined with its potential role in the maintenance of healthy blood sugar levels (which in itself is important for reproductive health), these potential impacts on ovulation and egg health explain why myo-inositol is one of the most common ingredients in preconception supplements for women. It’s often included in multi-ingredient blends for fertility and even in some prenatal vitamins.

Myo-inositol is not for everyone

Despite its popularity, myo-inositol is not for everyone, because of the way it works in the body. (You could say the same about DHEA: Because it’s a precursor to estrogen, it’s not recommended for women with estrogen-sensitive conditions like endometriosis.)

The key is the opposite roles they play in testosterone levels

One of the pathways through which myo-inositol may maintain normal ovulation and support egg health appears to be its effects on testosterone levels. Specifically, myo-inositol has been found to lower testosterone levels. This is good news for women with excessive androgens – those with PCOS, for instance.

In contrast, DHEA is a precursor to testosterone, meaning it’s partially converted into testosterone. Fertility specialists, including Dr. Gleicher, use DHEA in women with lower testosterone levels to maintain a healthy level of testosterone in the ovarian environment to support the health of eggs as they go through the final maturation process before ovulation.

So, myo-inositol and DHEA appear to play opposite roles when it comes to maintaining healthy testosterone levels for reproductive health, even though the ultimate purpose may be the same: supporting egg health. Whether you should consider one or the other depends on where your baseline testosterone is.

DHEA or myo-inositol to support egg health?

The first step is to figure out where you stand on testosterone levels.

• Talk to your doctor and figure out what it is that’s affecting your egg health.
• Ask for a testosterone test. Your doctor may recommend other tests, like DHEA-S (DHEA sulfate) and sex hormone binding globulin (SHBG) to get a better picture. Combined, these hormone levels can shed light on what’s happening to your reproductive health from the endocrine standpoint.
• You may find out that you don’t need either to support egg health. But definitely don’t take both DHEA and myo-inositol.

Pleaes reach out if you have questions about DHEA, myo-inositol and reproductive health. We are with you.