Two reviews of the same trials reached opposite verdicts a year apart
A meta-analysis of 26 trials called inositol effective and safe in 2023. The evidence review commissioned for the international guideline, from 30 trials, called it limited and inconclusive.
What the study found
Effective and safe, or limited and inconclusive: one evidence base
A meta-analysis of 26 randomised trials reached the first verdict in 2023. The evidence review commissioned for the international guideline reached the second the next year, from 30 trials, and added that metformin may beat inositol for hirsutism and waist-hip ratio.
The caveat · Both re-pool mostly small trials
Neither is a new trial: both are re-poolings of a literature made mostly of small studies. The earlier one stopped searching in October 2021, so it predates both the guideline's own review and the 2025 pregnancy trial. The later one could pool only 3 of the 13 comparisons it assessed.
What we don't know
Two reviews of the same inositol trials disagree on whether it works. The one calling it effective reports no live birth or pregnancy outcome, so the split is less about the trials than about what a reviewer calls enough.