EFFECT OF MYOINOSITOL IN FERTILITY PROFILE OF PCOS PATIENTS

Abstract

Introduction for Abstract

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women of reproductive age, characterized by anovulation, hyperandrogenism, and polycystic ovarian morphology, often leading to menstrual irregularities, infertility, and metabolic complications. Myoinositol, an insulin-sensitizing agent, has shown promise in addressing these symptoms by improving ovulatory function and hormonal balance. This study evaluates the efficacy of myoinositol in 73 PCOS patients, assessing its impact on fertility, menstrual regularity, hormonal profiles, skin manifestations, and ultrasonographic findings to provide insights into its therapeutic potential.

Objective: To evaluate the efficacy of myoinositol in improving the fertility profile, hormonal parameters, menstrual regularity, skin manifestations, and ultrasonographic findings in women with PCOS.

Methods: A prospective study was conducted on 73 PCOS patients treated with myoinositol. Data were collected on demographics, clinical presentations, hormonal profiles (LH, FSH, testosterone, progesterone, insulin), menstrual abnormalities, skin problems, infertility outcomes, & ultrasonographic findings (ovarian volume, follicle count). Pre- and post-treatment parameters were compared.
Results: The cohort (mean age 21.15 ± 3.32 years) predominantly presented with oligo/anovulation and hyperandrogenism (38.4%) or polycystic ovaries (35.6%). Menstrual abnormalities affected 86.3%, with amenorrhea (42.5%) and oligomenorrhea (32.9%) being most common. Myoinositol restored menses in all amenorrhea cases and 33.3%-66.7% of oligomenorrhea cases within 1-2.5 months, with better outcomes in patients with insulin levels ≤19.9 μU/ml. Hormonal improvements included significant reductions in LH (17.2 to 11.7 mIU/ml, p=0.0005), LH/FSH ratio (5.5 to 2.32, p=0.0098), testosterone (0.52 to 0.38 pg/ml, p=0.0002), fasting insulin (13.1 to 9.20 μU/ml, p<0.0001), and HOMA index (2.6 to 1.9, p<0.0001), alongside increased progesterone (0.86 to 1.1 ng/ml, p=0.0005). Skin manifestations improved moderately (e.g., 100% for moderate acne, 50% for acanthosis nigricans). Conception occurred in 66.7% of primary infertility cases but none in secondary infertility, yielding a 50% overall conception rate. Ultrasonographic findings showed significant reductions in ovarian volume (right: 11.7 to 6.3 cc, left: 9.9 to 4.91 cc, p<0.0001) and follicle count (p=0.0007-0.0031).
Conclusion: Myoinositol effectively improves menstrual regularity, hormonal profiles, ovarian morphology, and fertility in PCOS patients, particularly those with milder insulin resistance. Its effects on skin manifestations are comparable to metformin. These findings support myoinositol as a valuable therapeutic option for PCOS management, though further studies with larger cohorts and longer follow-up are needed to confirm its efficacy in secondary infertility and severe insulin resistance.