Abstract

Background: Previous studies have reported contradictory results regarding the effectiveness of metformin and myo-inositol on improving reproductive outcomes in patients with polycystic ovary syndrome (PCOS). Therefore, this study aimed to compare the effectiveness of these two drugs on improving reproductive outcomes of PCOS patients undergoing in vitro fertilization (IVF) treatment. Methods: This double-blind randomized clinical trial study was con­ducted on 140 infertile women with PCOS who were scheduled to undergo IVF in Yas Hospital, Tehran, Iran in 2020. The patients were randomly divided into two groups, including metformin and combination of myo-inositol and folic acid treatment groups. Reproductive outcomes were compared between the two groups. Results: The mean age of the patients was 30.66 ± 5.7 years (30.51 ± 5.88 in metformin treatment group and 30.9 ± 5.53 in myo-inositol group, P = 0.68). There was no significant difference between the two groups regarding the reproductive outcomes, including pregnancy rate, change in BMI, number and quality of oocytes, number and quality of embryos, follicle number, follicle size, ectopic pregnancy rate, and abortion rate (P > 0.05). Conclusion: There is no significant difference in the effect of metformin and myo-inositol on improving reproductive outcomes. Therefore, due to the lack of significant differences in the effectiveness of these two drugs and considering their availability and cost, one of them can be prescribed for the patients.

Highlights

  • Infertility is considered an inability to conceive, despite having regular unprotected intercourse for a year or inability to carry a pregnancy to full term 1

  • There is no significant difference in the effect of metformin and myo-inositol on improving reproductive outcomes

  • 140 patients were evaluated and classified into two groups. These patients were randomly assigned into two groups (70 patients in the metformin treatment group and 70 patients in the myo-inositol treatment group)

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Summary

Introduction

Infertility is considered an inability to conceive, despite having regular unprotected intercourse for a year or inability to carry a pregnancy to full term 1. Evidence-based studies showed its effects on myo-inositol as a food supplement in the treatment of metabolic complaints of reproduction such as PCOS in women, whereby it improves the quality of oocytes and embryo 10,11. Previous studies indicated a direct correlation between concentration of myo-inositol in the follicular fluid and high oocyte quality. Previous studies have reported contradictory results regarding the effectiveness of metformin and myo-inositol on improving reproductive outcomes in patients with polycystic ovary syndrome (PCOS). This study aimed to compare the effectiveness of these two drugs on improving reproductive outcomes of PCOS patients undergoing in vitro fertilization (IVF) treatment. Conclusion: There is no significant difference in the effect of metformin and myo-inositol on improving reproductive outcomes.

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