title: Ovulation induction with myo-inositol alone and in combination with clomiphene citrate in polycystic ovarian syndrome patients with insulin resistance.
abstract: BACKGROUND
  Insulin resistance plays a key role in the pathogenesis of polycystic ovarian syndrome (PCOS). One of the methods for correcting insulin resistance is using myo-inositol.
  
  
  OBJECTIVE
  The aim of the present study is to evaluate the effectiveness of myo-inositol alone or in combination with clomiphene citrate for (1) induction of ovulation and (2) pregnancy rate in anovulatory women with PCOS and proven insulin resistance.
  
  
  METHODS
  This study included 50 anovulatory PCOS patients with insulin resistance. All of them received myo-inositolduring three spontaneous cycles. If patients remained anovulatory and/or no pregnancy was achieved, combination of myo-inositol and clomiphene citrate was used in the next three cycles. Ovulation and pregnancy rate, changes in body mass index (BMI) and homeostatic model assessment (HOMA) index and the rate of adverse events were assessed.
  
  
  RESULTS
  After myo-inositol treatment, ovulation was present in 29 women (61.7%) and 18 (38.3%) were resistant. Of the ovulatory women, 11 became pregnant (37.9%). Of the 18 myo-inositol resistant patients after clomiphene treatment, 13 (72.2%) ovulated. Of the 13 ovulatory women, 6 (42.6%) became pregnant. During follow-up, a reduction of body mass index and HOMA index was also observed.
  
  
  CONCLUSIONS
  Myo-inositol treatment ameliorates insulin resistance and body weight, and improves ovarian activity in PCOS patients.
authors.affiliation: Clinic of Endocrinology, Alexandrovska University Hospital, Medical University , Sofia , Bulgaria .
authors.forename: Zdravko
authors.initials: Z
authors.lastname: Kamenov
authors.forename: Georgi
authors.initials: G
authors.lastname: Kolarov
authors.forename: Antoaneta
authors.initials: A
authors.lastname: Gateva
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Carlomagno
authors.forename: Alessandro D
authors.initials: AD
authors.lastname: Genazzani
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007231:Infant, Newborn; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D007294:Inositol / Q000008:administration & dosage* / Q000009:adverse effects; D007333:Insulin Resistance; D010062:Ovulation Induction / Q000009:adverse effects / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D055815:Young Adult
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene; D007294:Inositol
keywords: Anovulation; PCOS; clomiphene citrate; insulin resistance; myo-inositol