Comparison of Myoinositol plus Clomiphene Citrate versus Myoinositol plus Metformin for Management of Females Presenting with Polycystic Ovarian Syndrome

Abstract

Background: Infertility in women is frequently diagnosed with polycystic ovarian syndrome (PCOS). The precise presentation of the illness has been the subject of several research. Infertility patients with PCOS have recently been treated with Myoinositol, a new insulin sensitizer.

Objectives: To compare the outcome of regular ovulatory cycles and rate of conception of myoinositol plus clomiphene citrate versus myoinositol plus metformin for managing females presenting with polycystic ovarian syndrome and infertility.

Methodology: A total of 270 patients were included in the study through the Outpatient Department (OPD) of Obstetrics & Gynecology at Lahore Medical and Dental College, Lahore. Randomization was performed using the lottery method, ensuring equal distribution of participants into two groups. For this process, 135 folded slips labeled "A" and 135 labeled "B" were placed in a bowl. As each patient was enrolled, a slip was randomly drawn to determine their group allocation. Participants in Group A were prescribed 4g myo-inositol plus clomiphene citrate, while those in Group B received metformin 1500mg/day plus clomiphene citrate orally. Both groups were followed up for three months through regular OPD visits. During follow-up, ultrasonography was performed to assess ovulation, and a urine pregnancy test was conducted to evaluate treatment effectiveness.

Results: A comparison of both groups shows that 67.41% (n=91) in Group A and 57. 78% (n=78) in Group B had a regular ovulatory cycle; the p-value was 0.10. A comparison of both groups regarding the rate of conception shows that 26.37% (n=24) in Group A and 17.95% (n=14) in Group B had conception; the p-value was 0.19.

Conclusion: We concluded no difference in the outcome of patients with PCOS using myoinositol plus clomiphene citrate versus myoinositol plus metformin.