Choline and inositol in reproductive medicine: Molecular mechanisms, clinical evidence and prospects for personalized use
DOI:
https://doi.org/10.37800/RM.3.2026.897Keywords:
choline, myo-inositol, D-chiro-inositol, polyendocrine metabolic ovarian syndrome, insulin resistance, preconception careAbstract
Relevance: A woman’s metabolic and nutritional status is a potentially modifiable component of reproductive health. Among the nutrients of interest for preconception care and reproductive medicine, choline and inositol occupy a special place. Despite fundamental differences in their metabolism, both compounds are involved in cellular signaling and membrane homeostasis, while choline is closely associated with one-carbon metabolism and methylation, and inositol with insulin-dependent signaling mechanisms.
The study aimed to systematize current data on the molecular and biological roles of choline, myo-inositol, and D-chiro-inositol in the female reproductive system, to evaluate the evidence for their use in polyendocrine metabolic ovarian syndrome, infertility, and assisted reproductive technology programs, and to identify potential directions for personalized and combined use.
Materials and Methods: We conducted a narrative literature review with elements of a structured search. We analyzed publications identified primarily in the PubMed/MEDLINE database, including systematic reviews, meta-analyses, randomized controlled trials, observational studies, and international clinical guidelines. We prioritized publications from the past ten years and selected earlier foundational studies on choline and inositol metabolism. We also considered publications from 2025–2026.
Results: Choline supports membrane homeostasis, one-carbon metabolism, and methylation processes that are important for reproductive function and pregnancy. Inositol use in polyendocrine metabolic ovarian syndrome may improve insulin sensitivity, hormonal profile, menstrual cyclicity, and ovulation. In assisted reproductive technology programs, inositol has been reported to positively affect oocyte maturity and fertilization rates, supporting the prospects for personalized use of these nutrients.
Conclusion: Choline and inositol have complementary potential in maintaining female reproductive health. Their personalized use, considering dietary characteristics, metabolic phenotype, and the patient’s reproductive goals, represents a promising area for preconception care and assisted reproductive technology programs.
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