Abstract 30: A randomized control trial comparing myoinositol based therapy in combination with metformin versus metformin monotherapy on the clinical and hormonal parameters in obese reproductive age women with polycystic ovarian syndrome

Introduction: Insulin resistance is central to the pathogenesis of polycystic ovarian syndrome (PCOS). Metformin and myoinositol are insulin sensitizers which may act synergistically. Aims and Objectives: To study and compare the efficacy of Myoinositol based therapy with Metformin vs metformin monotherapy on clinical and hormonal parameters in young obese women with PCOS. Methods: All PCOS patients 17-40 years with BMI≥23 attending our department from December 2020 to December 2021, after excluding secondary causes and recent treatment, were randomized into intervention group: Metformin 500 mg BD + Myoinositol 1.1 g with D-Chiroinositol 27.6 mg BD and active comparator group: Metformin 500 mg BD. Weight, BMI, Waist Circumference (WC), modified Ferriman-Gallwey score (mFG), global acne score (GAS), fasting insulin, HOMAIR, serum testosterone, sex hormone binding globulin, free androgen index (FAI), LH:FSH ratio, anti-Mullerian hormone, ovarian volume were studied at baseline and after 3months of therapy. Changes in these variables were assessed and compared between the groups. Results: Total 32 patients were included, 16 in each group. One patient in each group became pregnant, two patients in metformin group discontinued due to adverse effects. WC and GAS decreased significantly in both groups. There was significant reduction in mFG, testosterone and FAI in patients receiving myoinositol and in weight, BMI, fasting insulin and HOMA IR in the metformin monotherapy group. Conclusion: Metformin alone and in combination with myoinositol based therapy have beneficial effect on clinical and hormonal parameters in PCOS.