Metformin <i>vs</i> myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study

Tagliaferri, Valeria; Romualdi, Daniela; Immediata, Valentina; Cicco, Simona De; Florio, Christian Di; Lanzone, Antonio; Guido, Maurizio

doi:10.1111/cen.13304

Cited by 32 publications

(28 citation statements)

References 37 publications

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“…Statistical significance was assumed when P < 0.05. 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.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

“…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.…”

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

“…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.…”

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

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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

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Pundir

Gudi

et al. 2019

Acta Obstet Gynecol Scand

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Introduction High levels of anti‐Mullerian hormone and a high antral follicle count in women with polycystic ovary syndrome, reflecting increased ovarian antral follicles, predisposes them to have a high number of retrieved oocytes with in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and an increased risk of ovarian hyperstimulation syndrome. Inositols, which act as insulin sensitizers, have the potential to alter folliculogenesis and the functional ovarian reserve, with subsequent benefits to reproductive outcomes following IVF/ICSI treatment. Published literature is, however, unable to provide definitive evidence of its efficacy. The objective of our review was to evaluate the effect of inositols on anti‐Mullerian hormone, antral follicle count and reproductive outcomes in women with polycystic ovary syndrome undergoing IVF/ICSI. Material and methods We performed a literature search using standard methodology recommended by Cochrane. Randomized controlled trials and non‐randomized studies comparing inositols with no treatment, placebo or other treatment were included in the review. Using standard methodology recommended by Cochrane we pooled results using the random effects model; our findings were reported as relative risk or mean differences. PROSPERO registration: CRD42017082275. Results We included 18 trials. The primary outcome was a change in anti‐Mullerian hormone and antral follicle count before and after treatment, for which data were unsuitable for meta‐analysis. A narrative review showed no consistent direction or size of effect. A meta‐analysis for the secondary outcomes showed no evidence of a significant difference between inositol and control groups for any outcome: number of oocytes (mean difference −0.39, 95% confidence interval [CI] −1.11 to 0.33), number of metaphase II oocytes (mean difference 0.29, 95% CI −0.83 to 1.40), number of top grade embryos (risk ratio [RR] 1.02, 95% CI 0.93‐1.12), clinical pregnancy rate (RR 1.16, 95% CI 0.87‐1.53), and risk of ovarian hyperstimulation syndrome (RR 0.73, 95% CI 0.39‐1.37). The quality of evidence was assessed as very low. Conclusions There is insufficient evidence for an effect of inositols on ovarian reserve markers and to support their use as pretreatment before IVF/ICSI in women with polycystic ovary syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

Section: Studies Assessing Changes In Ovarian Reserve Markersmentioning

confidence: 99%

See 2 more Smart Citations

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

Bhide

Pundir

Gudi

et al. 2019

Acta Obstet Gynecol Scand

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“…Even though there was a significant decrease in insulin response to glucose load, they did not find significant modifications in the clinical and biochemical parameters analyzed. 208 Although there has been extensive study of inositols in women with PCOS, the majority of these studies have been open label or poor-quality clinical trials. High-quality randomized controlled trials are needed with larger sample sizes, adequate allocation concealment, blinding, and full capture of adverse events.…”

Section: Human Studiesmentioning

confidence: 99%

Pharmacologic Treatment of Polycystic Ovary Syndrome: Alternate and Future Paths

Duguech

Legro

2017

Semin Reprod Med

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Polycystic ovary syndrome (PCOS) is a complex disorder which interacts with other genetic and environmental factors to cause dysregulation of steroidogenesis and anovulation as well as insulin resistance. Treatments which address the long-term effects of this unique combination of reproductive and metabolic dysfunction are needed. Over the past decade, new insights into the genetic factors of PCOS and biotechnological advances have led to potential treatments for women with PCOS. These treatments include both new potent pharmaceutical compounds and repurposed drugs which target different steps in metabolic-reproductive pathways to improve long-term health of women with PCOS. These new therapies target key enzymes involved in steroidogenesis, regulatory pathways of gonadotropin secretion, or lower oxidative stress. We review in this article the current common treatments of PCOS, recent developments in the field, and current information on the mode of action, efficacy, and safety of emerging therapeutic compounds.

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Inositol for subfertile women with polycystic ovary syndrome

Showell

Mackenzie‐Proctor

Jordan

et al. 2018

Cochrane Database of Systematic Reviews

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Metformin vs myoinositol: which is better in obese polycystic ovary syndrome patients? A randomized controlled crossover study

Abstract: Both treatments improved the glyco-insulinaemic features of obese PCOS patients, but only metformin seems to exert a beneficial effect on the endocrine and clinical features of the syndrome.

Cited by 32 publications

References 37 publications

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

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

Pharmacologic Treatment of Polycystic Ovary Syndrome: Alternate and Future Paths

Inositol for subfertile women with polycystic ovary syndrome

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