A randomised clinical trial comparing myoinositol and metformin in PCOS

Background: The medical management of PCOS is fast changing from the combination hormonal pills/progesterone for cycle regularisation, cosmetological treatment of acne and hirsutism to management of obesity and insulin resistance. This study evaluates the effects of the insulin sensitisers in improving the clinical and hormonal alterations in cases of PCOS and improving the reproductive outcomes.Methods: This 3-arm prospective randomized comparative study was done from August 2015 to July 2016 in the Department of Obstetrics and Gynaecology at SCB MCH, Cuttack wherein patients of PCOS were studied based on treatment with metformin, myoinositol or both.Results: Myoinositol helped in the resumption of spontaneous menstrual cycles in 66.66% of women with PCOS with menstrual complaints, whereas the same effect in patients who took metformin was only in 15.78%, which was not significant. Use of myoinositol in Infertile women with PCOS resulted in a pregnancy in 57.14% of women, without the need of any ovulation inducing agent while use of metformin gave a pregnancy in all the 9 patients, thought 5 out of them required clomiphene citrate for ovulation induction. With myoinositol there was a reduction in weight, BMI, LH/FSH ratio, acne and hirsutism. Metformin has resulted in a decrement of body weight, BMI and acne only.Conclusions: This study conclusively proves that myoinositol has a definitive role in decreasing the ovarian dysfunction of PCOS. There has been a significant improvement in the symptom profile, weight loss and a significant change in the hormonal parameters.