Evaluating Hormonal Modulation in PCOS-Related Infertility: Metformin Alone Versus Metformin Plus Myoinositol in a Randomized Controlled trial

Abstract

Objective: To compare the benefits of metformin with myo-inositol to metformin alone on hormonal profile in women with polycystic ovarian syndrome (PCOS) who are unable to conceive.

Methodology:

A double-blinded, randomize d controlled experiment was carried out from September 2022 to February 2023. 114 PCOS females who were infertile were randomly assigned to Group A (n=57) took Metformin orally in a dose of 500 mg 3 times per day plus oral Myo-inositol 4 g once daily; Group B (n=57) received oral Metformin 500 mg three times a day only. It was suggested to the subjects to try for spontaneous conception. All the parameters of the hormonal and metabolic profile were measured at baseline after initiating therapy and then at one month, three months, and six months. The main aim of this study was establishment of clinical pregnancy and improvement of hormonal profile in terms of mean changes in serum LH/FSH ratio, mean serum Progesterone and serum Anti Müllerian Hormone over a period of 1 month, 3 months and 6 months. Both groups baseline demographic, hormonal, bio-chemical and clinical traits were the same.

Results:

Significant progress was made in mean serum LH/FSH ratio (p=0.00), serum Progesterone (p=0.00) and serum Anti Müllerian Hormone (p=0.00) in Group A as compared to Group B. Number of clinical pregnancies were higher in Group A as compared to Group B [27.3 % (15/55); 14.8% (8/54); p=0.113] although not statistically significant.

Conclusion:

Metformin and myo-inositol together considerably ameliorated the hormonal profile and raised fertility in contrast to metformin alone.