Different Effects of Myoinositol plus Folic Acid versus Combined Oral Treatment on Androgen Levels in PCOS Women

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.

The effect of myo‐inositol/di‐chiro‐inositol on markers of ovarian reserve in women with PCOS undergoing IVF/ICSI: A systematic review and meta‐analysis

“…When published articles were unclear about the presence and amount of missing data, the original investigators [16][17][18][19][20][21][22][23][24][25] of the trial were contacted to request this information. We were able to get this information from Colazingari et al, 18 Ozay et al 21 have updated the risk of bias accordingly. Although we were not able to get information from some authors, the required data were available in a previously published systematic review 26 from which it was extracted.…”

“…Two of the seven included studies were RCTs 16,24 and five were nonrandomized studies. 21,23,[28][29][30] All the studies were single-center studies with five of the seven studies conducted in Italy, one in Turkey and one in Georgia. In total, 415 women were recruited to these seven studies.…”

“…We have, however, included the study in our review as a consensus by international pediatric subspecialty societies states that a persistence of hyperandrogenic anovulation for ≥2 years distinguishes PCOS from physiologic anovulation. 31 Five of the included studies 21,23,24,28,29 assessed MI in varying doses ranging from 1 to 4 g daily and for varying durations between 12 weeks and 6 months with no explanations for variations in dose or duration of given treatment. Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC.…”

“…31 Five of the included studies 21,23,24,28,29 assessed MI in varying doses ranging from 1 to 4 g daily and for varying durations between 12 weeks and 6 months with no explanations for variations in dose or duration of given treatment. Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC. 21,28,29 Two of the studies 16,30 assessed the effects of DCI in doses ranging from 1000 to 1500 mg daily for durations from 180 days to 13 months.…”

“…Four of these looked at its effect on serum AMH 21,23,24,29 and three looked at its effect on AFC. 21,28,29 Two of the studies 16,30 assessed the effects of DCI in doses ranging from 1000 to 1500 mg daily for durations from 180 days to 13 months. One of these assessed the effect of DCI on serum AMH 30 and the other assessed its effect on AFC.…”