Insulin sensitiser agents alone and in co-treatment with r-FSH for ovulation induction in PCOS women

Gynecol Endocrinol. 2010 Apr;26(4):275-80. doi: 10.3109/09513590903366996.


Objective: The aim of this study was to compare the effectiveness of myo-inositol (MYO) and metformin, in monotherapy or in association with recombinant follicle stimulating hormone (r-FSH), in the treatment of menstrual irregularities, chronic anovulation, and female infertility in patients with polycystic ovary syndrome (PCOS).

Materials and methods: One hundred twenty patients were randomly treated with metformin 1500 mg/day orally (n = 60), or 4 g MYO plus 400 microg folic acid daily (n = 60), continuously. If no pregnancy occurred, r-FSH (37.5 units/day) was added to the treatment for a maximum of three attempts.

Results: Fifty percent of the patients who assumed metformin restored spontaneous ovulation, 18.3% of these obtained pregnancy. The remaining 42 patients were treated with metformin plus r-FSH. Pregnancy occurred in a total of 11 women (26.1%). The total pregnancy rate was 36.6%. Sixty-five percent of the patients treated with MYO plus folic acid restored spontaneous ovulation activity, 30% of these obtained pregnancy. The remaining 38 patients were treated with MYO, folic acid plus r-FSH. Pregnancy occurred in a total of 11 women (28.9%). The total pregnancy rate was 48.4%.

Conclusions: Both metformin and MYO, can be considered as first line treatment for restoring normal menstrual cycles in most patients with PCOS, even if MYO treatment seems to be more effective than metformin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anovulation / drug therapy
  • Dietary Supplements
  • Drug Therapy, Combination
  • Female
  • Fertility Agents, Female / therapeutic use
  • Folic Acid / therapeutic use
  • Follicle Stimulating Hormone / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Infertility, Female / drug therapy*
  • Inositol / therapeutic use*
  • Menstruation Disturbances / drug therapy
  • Metformin / therapeutic use*
  • Ovulation Induction / methods*
  • Polycystic Ovary Syndrome / complications*
  • Pregnancy
  • Pregnancy Rate
  • Young Adult


  • Fertility Agents, Female
  • Hypoglycemic Agents
  • Inositol
  • Follicle Stimulating Hormone
  • Metformin
  • Folic Acid