Therapeutic Potential of Myo-Inositol in Male Infertility: Correction of Spermatogenesis Parameters and Oxidative Stress (Review)

INTRODUCTION. Male infertility, in particular reproductive system deficiency, is often associated with oxidative stress. Myo-inositol antioxidant properties are essential for various biochemical and cellular processes in spermatozoa; for example, they contribute to mitochondrial function and sperm motility. This creates an opportunity to use inositol in the complex infertility treatment of various aetiology, including oligoasthenoteratozoospermia, asthenozoospermia, and in assisted reproductive technologies. AIM. This study aimed to evaluate the possibility and effectiveness of using inositol for spermatogenesis restoration in male reproductive dysfunction caused by oxidative stress. DISCUSSION. Oxidative stress damages sperm cell membrane, causes mitochondrial dysfunction, and affects DNA. Studies show that myo-inositol positively impacts spermatogenesis due to its antioxidant properties and activation of mitochondrial metabolism. It promotes ATP production, reduces oxidative damage markers, decreases DNA fragmentation and improves sperm morphology. Moreover, myo-inositol increases cellular testosterone, optimises actin — globulin binding, thus enhancing sperm motility, and modulates intracellular calcium concentrations necessary for oxidative metabolism and ATP synthesis. Clinical studies have shown that inositol increases overall sperm motility by 20–30%; progressive motility — up to 40%; fertilisation rate — by 10–15%, and reduces DNA fragmentation by 3–5%. Myo-inositol used for sperm cryopreservation reduces reactive oxygen and apoptosis, maintains mitochondrial membrane potential, and increases oxidative phosphorylation efficiency by 6–15%. CONCLUSIONS. Myo-inositol is a promising therapeutic compound for treating male infertility of various aetiology, including oligoasthenoteratozoospermia, asthenozoospermia, and for preparing sperm in assisted reproductive technologies. Also, due to its antioxidant properties, myo-inositol can be recommended in suspected or confirmed oxidative damage to sperm. However, large controlled trials are needed to confirm positive effect of myo-inositol on male reproductive function.