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In a pooled analysis of multiple randomised controlled trials, the myo-inositol and D-chiro-inositol combination in a 40:1 ratio demonstrated improvements in ovulation rates, menstrual cyclicity, and markers of insulin resistance in women with PCOS. The effect was most pronounced in participants with elevated fasting insulin at baseline. Tolerability was generally high with minimal adverse events reported across studies.

In a systematic review and meta-analysis of inositol supplementation for PCOS, the 40:1 ratio of myo-inositol to D-chiro-inositol was associated with improved ovulation rates compared to placebo, with a number needed to treat of approximately 5. The effect on testosterone reduction was moderate but consistent across trials. Notably, the benefits appeared most significant in women with elevated HOMA-IR at baseline, suggesting insulin-resistant phenotypes derive the greatest benefit from inositol supplementation.