Abstract

COMPARATIVE STUDY ON EFFICACY AND SAFETY OF MYOINOSITOL VERSUS METFORMIN IN WOMEN WITH PCOS

Chinthana G.*

ABSTRACT

Introduction: Polycystic ovarian syndrome (PCOS) or stein-leventhal syndrome is a most common endocrine disorder, affecting 20% of reproductive age women in terms of absence of ovulation and fertility, impaired glucose tolerance and a defect in the insulin signalling pathway which seems to be implicated in the pathogenesis of insulin resistance. For this reason, insulin lowering medications represent novel approach in women with PCOS. Objective: To evaluate the efficacy and safety of Myoinositol(MI) versus Metformin in women with PCOS. Material and Methods: Interventional prospective, open labelled, parallel arm, randomized control study conducted in OG department of Chennai Medical College Hospital and Research Centre, Irungalur, Tiruchirappalli. Total of 132 patients were recruited according to Rotterdams criteria, out of which 90 PCOS patients were randomly divided in to 3 groups of 30 each with Group I as placebo; Group II to receive Metformin 500mg; and Group III with Myoinositol 2mg. Hormonal parameters and ultrasonogram were carried out during the study period. Statistical analysis was carried out by Students’s paired‘t’ test with P value of < 0.05 was considered to be statistically significant. The end points noted were improvement in hormonal profile, ovulation and fertility rate in women with PCOS. Results: After treatment with Myoinositol our study showed significant reduction in F.Testo, DHEAS, LH, LH/FSH, Fasting insulin at 12th wk, 12th wk, 4th wk, 8th wk, 12th wk (earlier weeks) compared to that of Metformin. This study showed improved ovulation rate and fertility rate in patients treated with MI compared to metformin. And moreover MI treated group did not showed any adverse events. Conclusion: Though metformin and MI can be considered as first line treatment in PCOS, MI seems to be more effective than metformin in improving the hormonal profile, reproductive axis functioning with subsequent frequency of ovulation and pregnancy outcomes. It is a safe and effective drug in terms of very minimal or nil side effects compared to placebo and metformin. It could be included in the treatment protocol of infertility in the near future.

Keywords: Polycystic ovarian syndrome, Myoinositol, Metformin, ovulation, fertility, hormonal profile.