Objective: To assess the efficacy of myo-inositol and metformin alone or in combination with letrozol for inducing ovulation and achieving pregnancy in anovulatory women with polycystic ovary syndrome.
Methodology: This randomized case-controlled study included 92 women with anovulatory polycystic ovarian syndrome with infertility of at least one year. They were divided into two groups; group 1 included 44 women who received metformin, inositol and letrozole and group 2 included 48 women who received metformin and inositol for 6 months. We assessed their effect on menstrual cycle, ovulation rate, pregnancy rate and serum testosterone.
Results: Both groups had significantly shorter cycles following therapy (p=0.004 and 0.003, respectively). In group 1, 32 out of 44 females ovulated, but in group 2, only 16 out of 48 females ovulated (72.7 vs. 33.3%, respectively). Pregnancy rate was similarly higher in group 1 (54.5 vs. 27.1%). After therapy, individuals in group 1 had significantly lower testosterone levels (55.16±16.33 versus 59.15±23.44; p=0.044).
Conclusion: We conclude that the combination of metformin and inositol with letrozol in patients with polycystic ovarian syndrome may generate a more positive outcome in terms of increased ovulation and pregnancy rate, restoration of menstruation and decreased hyperandrogenism.
Key words: Polycystic ovarian syndrome, ovulation induction, metformin, inositol, letrozol.
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