Myo-Inositol: The New Challenge in Treatment of Polycystic Ovary with Infertility.

Introduction: Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine disorder in women of reproductive age, affecting approximately 6–15% of them associated with chronic anovulation. Myo-inisitol is insulin-sensitizing agent ingested with food and actively synthetized in liver and brain. Aim of the work: To study the effect of Myo-inositol and Metformin in treatment of PCOS with infertility in Tobruk-Libya. Methods: The study group included 800 selected cases of PCOS with infertility and insulin resistance, diagnosed and treated in Gynecology and Obstetrics department of Tobruk Medical Center, Libya, from January 2018 to January 2022. Patients then were randomly distributed into two groups; Group 1 (n = 400) in which Myo-inositol 2000 mg daily by taking two tablets (2x500 mg) after breakfast and another tow tablets after dinner and take Metformin 850 mg during lunch. Group 2 (n = 400) in which they take Metformin 850 mg during lunch only. All patients were followed up by ultrasound to see the progress of ovulation. Results: The mean age of the patients at group 1 is 29 years (range, 18–40 years) and at group 2 is 32 years (range, 22–42 years). Mean pre-study serum glucose level is 193 mg/dl in group 1 and 208 mg/dl in group 2. Mean pre- study Insulin level is 284 mIU/L in group 1 and 295 mIU/L in group 2. There are highly significant relationship between treatment with Myo-inisitol and Metformin (Group-1) with serum glucose level, serum insulin level, acne, hirsutism, body weight, menstrual cycle regularity, follicles diameter and pregnancy. Conclusion: Our results shows that use of Myo- inositol and Metformin is a useful treatment of polycystic ovary with infertility with improvement of laboratory, clinical and ovulation with subsequent pregnancy.