Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women.
OBJECTIVE
The aim of this study was to compare the effectiveness of myo-inositol (MYO) and metformin, in monotherapy or in association with recombinant follicle stimulating hormone (r-FSH), in the treatment of menstrual irregularities, chronic anovulation, and female infertility in patients with polycystic ovary syndrome (PCOS).


METHODS
One hundred twenty patients were randomly treated with metformin 1500 mg/day orally (n = 60), or 4 g MYO plus 400 microg folic acid daily (n = 60), continuously. If no pregnancy occurred, r-FSH (37.5 units/day) was added to the treatment for a maximum of three attempts.


RESULTS
Fifty percent of the patients who assumed metformin restored spontaneous ovulation, 18.3% of these obtained pregnancy. The remaining 42 patients were treated with metformin plus r-FSH. Pregnancy occurred in a total of 11 women (26.1%). The total pregnancy rate was 36.6%. Sixty-five percent of the patients treated with MYO plus folic acid restored spontaneous ovulation activity, 30% of these obtained pregnancy. The remaining 38 patients were treated with MYO, folic acid plus r-FSH. Pregnancy occurred in a total of 11 women (28.9%). The total pregnancy rate was 48.4%.


CONCLUSIONS
Both metformin and MYO, can be considered as first line treatment for restoring normal menstrual cycles in most patients with PCOS, even if MYO treatment seems to be more effective than metformin.
Raffone
Emanuela
E
Obstetrics and Gynecology Department, G. Martino Hospital, Messina, Italy. emaraff@gmail.com
Rizzo
Pietro
P
Benedetto
Vincenzo
V
D000328:Adult; D000858:Anovulation / Q000188:drug therapy; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005492:Folic Acid / Q000627:therapeutic use; D005640:Follicle Stimulating Hormone / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007247:Infertility, Female / Q000188:drug therapy*; D007294:Inositol / Q000627:therapeutic use*; D008599:Menstruation Disturbances / Q000188:drug therapy; D008687:Metformin / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D055815:Young Adult
D005300:Fertility Agents, Female; D007004:Hypoglycemic Agents; D007294:Inositol; D005640:Follicle Stimulating Hormone; D008687:Metformin; D005492:Folic Acid