Abstract
Recently, myoinositol (myo-ins) and folic acid combination has gained an important role for treating Polycystic Ovary Syndrome (PCOS), in addition to combined oral contraceptives (COC). We aimed to examine myo-ins effects on anti-Mullerian hormone (AMH) levels and compare them with those ones obtained administering COC. In this prospective study, 137 PCOS patients, diagnosed according to Rotterdam criteria and admitted to the Reproductive Endocrinology and Infertility Outpatient Clinic at Dokuz Eylul University (Izmir, Turkey), were included. After randomization to COC (n = 60) and myo-ins (n = 77) arms, anthropometric measurements, blood pressure, Modified Ferriman Gallwey scores were calculated. Biochemical and hormonal analysis were performed, and LH/FSH and Apo B/A1 ratios were calculated. Data analysis was carried out in demographically and clinically matched 106 patients (COC = 54; myo-ins = 52). After 3-month treatment, increase in HDL and decreases in LH and LH/FSH ratio were statistically more significant only in COC group when compared with baseline (in both cases p > 0.05). In myo-ins group, fasting glucose, LDL, DHEAS, total cholesterol, and prolactin levels decreased significantly (for all p < 0.05). Progesterone and AMH levels, ovarian volume, ovarian antral follicle, and total antral follicle counts lessened significantly in both groups (for all p < 0.05). In PCOS treatment, MYO is observed more effective in reductions of total ovarian volume and AMH levels.
Highlights
Anti-Mullerian hormone (AMH), a polypeptide, secreted by the granulosa cells of the preantral and early developing antral follicles, has been shown to be a predictor of ovarian activity [1]
Evidence suggests that insulin resistance and its compensatory hyperinsulinemia play an important role in Polycystic Ovary Syndrome (PCOS) pathogenesis [5, 6]
The baseline biochemical and hormonal values showed that patient groups were matched in these parameters except sex hormone binding globulin (SHBG) level which was higher in group 1 (Table 2)
Summary
Anti-Mullerian hormone (AMH), a polypeptide, secreted by the granulosa cells of the preantral and early developing antral follicles, has been shown to be a predictor of ovarian activity [1]. PCOS patients show an increased number of antral follicles; they have higher circulating AMH levels than the healthy women [2]. Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder, affecting 6–10% of women in reproductive age. This syndrome is characterized by biochemical or clinical signs of hyperandrogenism, chronic anovulation, and polycystic ovaries [4]. It is frequently associated with insulin resistance and obesity. Insulin is associated with hyperandrogenism; it acts synergistically with luteinizing hormone to increase the androgen production of theca cells [7]. Administration of insulin sensitizers ameliorates hyperandrogenemia and ovulatory functions [8]
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