The effectiveness of inositol and metformin on infertile polycystic ovary syndrome women with resistant to letrozole

Pourghasem, Sajadeh; Bazarganipour, Fatemeh; Taghavi, Seyed Abdolvahab; Kutenaee, Maryam Azizi

doi:10.1007/s00404-019-05064-5

Cited by 14 publications

(17 citation statements)

References 19 publications

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“…The dose of myo-inositol varied per study ranging from 1200 mg per day to 8000 mg per day in divided doses. One study used only myo-inositol [14], the other four combined myo-inositol with folic acid [15][16][17][18]; and three studies included treatment arms that combined myo-inositol with metformin [2,14]. One study also used myo-inositol with its other form, which is d-chiro-inositol [19], and another one with melatonin.…”

Section: Study Selectionmentioning

confidence: 99%

“…[17] Treatment duration lasted from two months [15] up to six months [2,19]. Three studies [16][17][18] had three months duration and one study lasted for four months. [14] The study population (Table 2) included patients in their reproductive age (ranges 15-45 years old) diagnosed with PCOS based on the Rotterdam criteria.…”

Section: Study Selectionmentioning

confidence: 99%

“…Among the studies, five RCTs included patients who failed to conceive for more than one year. [2,[15][16][17][18] The mean BMI of the sample population ranged from 22 to 29.9 kg/m 2 . Three studies reported baseline cycle length ranging from 32 days to 2.04 months [2,17], and the study of Chirania, et al, (2017) reported that -14% of their sample population had irregular menses.…”

Section: Study Selectionmentioning

confidence: 99%

“…All seven studies were assessed as having some risk of bias (Figure 7). Incomplete or poor reporting of allocation concealment and blinding of authors impacted the assessment, and consequently an unclear risk of bias was determined in three studies [2,15,18]. Four studies were found to have high risks of bias in two domains including concealment [14,19], and blinding.…”

Section: Bias Assessmentmentioning

confidence: 99%

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Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

Sigue¹,

Decena²

2022

JMUST

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Background: Polycystic ovarian syndrome (PCOS) is a common, reproductive endocrinopathy associated with ovarian dysfunction, cardiovascular disorders, obesity, and infertility. Myo-inositol is a novel treatment for women with PCOS that claimed to have improved fertility rate in this population. This systematic review and meta-analysis examined the effect of myo-inositol on pregnancy rate, menstrual cycle, and adverse effects from randomized controlled trials (RCTs). Methods: RCTs that evaluated the efficacy of myo-inositol in improving pregnancy rate and regulation of menstrual cycle in women with PCOS. Electronic databases were searched and studies published up to October 24, 2021 were included in the systematic review and meta-analysis. Study selection and assessment of quality were conducted independently by two review authors. Results: Seven studies with 729 patients treated with myo-inositol and 677 patients treated with placebo and/or metformin were included in the analysis. The research groups did not diverge significantly in terms of basic characteristics, such as age, adnexal or uterine pathology, body mass index, and duration of infertility. In the myo-inositol group, regulation of the normal menstrual cycle is at 20%, significantly higher than the metformin group at 12%, (p<0.001). However, there is no significant difference in the pregnancy rate between myoinositol and placebo (p=0.42) and/or metformin (p=0.17). Conclusion: This systematic review and meta-analysis showed that myo-inositol can be an alternative treatment for PCOS in terms of regulation of menses and may improve the success of spontaneous pregnancies. However, additional randomized, double-blind controlled trials with larger sample sizes, low heterogeneity, and uniform inclusion criteria are recommended to establish the effects of myo-inositol on PCOS treatment and pregnancy rate.

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Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Study Selectionmentioning

confidence: 99%

Section: Bias Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

Sigue¹,

Decena²

2022

JMUST

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“…Following title and abstract screening, 408 full-text articles were retrieved and screened for eligibility. Of them, 307 articles were excluded, and 101 RCTs [20-32, 33, 34-43, 44, 45- [121][122][123][124][125][126][127][128][129][130][131][132][133][134][135][136], however, they could not be added to our analysis due to the following causes: five studies failed to meet our BMI criteria , three studies included irrelevant interventions [133][134][135], two studies had an open-label design [127,128], two studies measured different outcomes [131,132], one study had a cost-effectiveness design [121], one study had a post-hoc design [129], one study had no treatment control [122], and one study included pregnant patients [130]. Additionally, the bibliography of the included RCTs was manually searched, but no further records were added.…”

Section: Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

The comparative effectiveness of 55 interventions in obese patients with polycystic ovary syndrome: A network meta-analysis of 101 randomized trials

et al. 2021

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Background Polycystic ovary syndrome (PCOS) affects up to 18% of reproductive-age females. The prevalence of obesity in PCOS patients reaches up to 80%, which is 2-fold higher than the general population. Objective The present study aimed to compare the effectiveness of 55 pharmacological interventions across 17 different outcomes in overweight/obese PCOS patients with hyperandrogenism manifestations for both short- and long-term follow-ups. A comprehensive literature search was performed on PubMed, Scopus, Embase, Science Direct, Web of Science, and Cochrane CENTRAL for randomized controlled trials comparing any conventional pharmacological intervention as a monotherapy or a combination in overweight/obese patients with polycystic ovary syndrome and hyperandrogenism manifestations. Extracted data included three main parameters; I. Anthropometric parameters (BMI, Waist and Hip circumferences, and Waist/HIP ratio), II. Hormonal parameters (FSH, LH, FSG, SHBG, Estradiol, Total Testosterone, Free testosterone, DHEAS, Androstenedione), and III. Metabolic parameters (Total Cholesterol, LDL-C, HDL-C, Triglycerides, Fasting glucose, Fasting glucose, HOMA-IR). Critical appraisal and risk of bias assessments were performed using the modified Jadad scale, and the overall quality of this network meta-analysis was evaluated according to the CINeMA framework. We performed both a pairwise meta-analysis and a network meta-analysis to evaluate the effect sizes with 95% CI, and we calculated the surface under the cumulative ranking curve (SUCRA) for each intervention. Results Our final search on May 15th 2021 retrieved 23,305 unique citations from searching six electronic databases. Eventually, 101 RCTs of 108 reports with a total of 8,765 patients were included in our systematic review and multi-treatments meta-analysis. 55 different interventions were included: 22 monotherapies, and 33 combinations. The two-dimensional cluster ranking of the average SUCRA values for metabolic and hormonal parameters with significant estimates revealed flutamide (77.5%, 70%; respectively) as the highest and rosiglitazone (38.2%, 26.3%; respectively) as the lowest, in terms of the overall efficacy in reducing weight and hyperandrogenism. However, cyproterone-acetate+ethinylestradiol exhibited a higher ranking in improving hormonal parameters (71.1%), but even a lower-ranking regarding metabolic parameters (34.5%). Conclusions and relevance Current evidence demonstrated the superiority of flutamide in improving both metabolic and hormonal parameters, and the higher efficacy of cyproterone-acetate+ethinylestradiol only in improving hormonal parameters. Nearly all interventions were comparable in female hormones, FGS, HDL, glucose, and insulin levels improvements.

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Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis

et al. 2023

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The effectiveness of inositol and metformin on infertile polycystic ovary syndrome women with resistant to letrozole

Cited by 14 publications

References 19 publications

Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

Efficacy of Myo-inositol in Improving Pregnancy Rate and Regulation of Menstrual Cycle for Patients With Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis

The comparative effectiveness of 55 interventions in obese patients with polycystic ovary syndrome: A network meta-analysis of 101 randomized trials

Effects of myo-inositol vs. metformin on hormonal and metabolic parameters in women with PCOS: a meta-analysis

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