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In healthy women, the ratio of myo-inositol to D-chiro-inositol in ovarian fluid is about 100:1, but in women with PCOS, it can drop to 0.2:1

J Biol Chem 1934

Two downstream consequences are mechanistically central: nicotinamide is preserved for re-entry into the NAD+ salvage pathway (raising intracellular NAD+ availability), and SAM is preserved for other methylation reactions