Integrated Clinical Evidence for Celine® in Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): From Metabolic Correction to Improved Fertility
Jehan Elfarjani,
Inas A Yahea,
Patrick Choueiry
Background: Polyendocrine metabolic ovary syndrome (PMOS) is the most common endocrine disorder
affecting women of reproductive age and represents a leading cause of anovulatory infertility. Beyond
reproductive dysfunction, PMOS is characterized by insulin resistance, oxidative stress, chronic low-
grade inflammation, and hyperandrogenism, all of which contribute to impaired folliculogenesis and
reduced fertility. Celine® is a nutraceutical formulation combining myo-inositol, alpha-lipoic acid, and
N-acetylcysteine, three compounds with complementary insulin-sensitizing and antioxidant properties.
Several clinical studies have evaluated its use in different PMOS populations; however, the available
evidence has not previously been synthesized into a single comprehensive review.
Objective: To integrate and critically evaluate the published clinical evidence on Celine® across
different stages of PMOS management, including metabolic control, restoration of ovulation, and
assisted reproductive technology (ART) outcomes.
Methods: A narrative integrated evidence review was performed using all three currently published
clinical studies evaluating Celine® in women with PMOS. Three clinical investigations involving
approximately 1,000 women were included: two randomized controlled trials and one prospective chart
review. Evidence was synthesized descriptively according to major clinical outcome domains rather
than statistically pooled because of differences in study design, patient populations, interventions,
comparators, and outcome definitions.
Results: Across all included studies, Celine®-containing regimens consistently demonstrated favorable
effects on reproductive and metabolic outcomes. Reported benefits included improvements in insulin
resistance and glycemic control, menstrual regularity, ovulation, pregnancy rates, follicular development,
mature oocyte yield, embryo quality, and ovarian stimulation efficiency during ART. Although outcome
measures were heterogeneous and therefore unsuitable for formal meta-analysis, the consistency of effect
direction across complementary clinical settings supports the biological plausibility of the intervention
and suggests potential benefits throughout the continuum of PMOS management.
Conclusions: The currently available evidence indicates that Celine® may represent a promising
adjunctive therapeutic strategy for women with PMOS by simultaneously targeting the metabolic
disturbances and reproductive dysfunction underlying the disorder. While the consistency of findings
across the available studies is encouraging, the evidence remains limited by heterogeneous study designs
and the absence of independent replication. Additional multicenter, adequately powered randomized
controlled trials are required to confirm these findings, establish long-term reproductive outcomes, and
define the optimal place of Celine® within contemporary PMOS management.
10.33425/2768-0304.1039
Published: 08 Nov, 2026