Efficacy of Myo-Inositol plus D-Chiro-Inositol versus Metformin in the Management of Polycystic Ovary Syndrome among Obese Infertile Women in Bangladesh

Open Access

Abstract

Background: Polycystic Ovary Syndrome (PCOS) in obese infertile women is commonly associated with insulin resistance, hyperandrogenism, and ovulatory dysfunction. Metformin is widely used for improving metabolic and reproductive outcomes, while Myo-Inositol plus D-Chiro-Inositol (MI+DCI) offers a potentially safer, insulin-sensitizing alternative with fewer gastrointestinal side effects. Aim of the Study: To compare the efficacy of MI+DCI versus metformin in improving metabolic, hormonal, and reproductive outcomes among obese infertile women with PCOS in Bangladesh. Methods & Materials: In this randomized controlled study, 80 obese infertile women with PCOS were allocated into two groups: MI+DCI (n=40) and metformin (n=40). Baseline demographic, metabolic, and hormonal profiles were recorded. Participants received their respective therapies for six months. Post-treatment assessment included BMI, fasting glucose and insulin, HOMA-IR, LH, FSH, LH/FSH ratio, total testosterone, menstrual regularity, ovulation, conception rates, and adverse effects. Statistical analysis was performed using SPSS v26; p ≤0.05 was significant. Results: MI+DCI significantly reduced BMI (29.74±2.41 vs 30.85±2.33 kg/m², p=0.03), fasting glucose (90.52±7.65 vs 95.48±8.14 mg/dl, p=0.01), fasting insulin (12.35±3.02 vs 15.84±3.65 µIU/ml, p<0.001), HOMA-IR (2.62±0.84 vs 3.45±0.96, p<0.001), serum LH (7.12±1.94 vs 8.84±2.10 mIU/ml, p=0.001), LH/FSH ratio (1.15±0.41 vs 1.48±0.45, p=0.002), and total testosterone (49.28±11.42 vs 58.15±12.36 ng/dl, p=0.001) compared to metformin. Menstrual regularity (75% vs 55%, p=0.04) and ovulation rate (70% vs 47.5%, p=0.03) were also significantly higher. Adverse effects were significantly fewer with MI+DCI. Conception rates were higher but not statistically significant. Conclusion: MI+DCI is more effective than metformin in improving metabolic, hormonal, and ovulatory outcomes among obese infertile women with PCOS, with superior tolerability and fewer gastrointestinal adverse effects, supporting its use as a safer alternative or adjunct to metformin.