Study: Insulin sensitors in the treatment of PCOS

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Diese Studie untersuchte die Wirksamkeit von Insulinsensibilisatoren zur Ovulationsinduktion bei Patientinnen mit polyzystischem Ovarialsyndrom (PCOS) und Unfruchtbarkeit. In der randomisierten, kontrollierten klinischen Studie wurden 120 Patientinnen entweder mit Metformin oder Myo-Inositol plus Folsäure behandelt. Der primäre Endpunkt war die Wiederherstellung des spontanen Eisprungs. Sekundäre Endpunkte waren die Resistenz gegen die Behandlung, die Schwangerschaftsrate und die Abtreibungsrate. Die Ergebnisse zeigten, dass Myo-Inositol gegenüber Metformin einen statistisch signifikanten Unterschied in der Wiederherstellung des spontanen Eisprungs aufwies. Patientinnen, die Myo-Inositol erhielten, zeigten auch eine höhere Schwangerschaftsrate. Die Autoren empfehlen Myo-Inositol als Erstlinienbehandlung für Patientinnen mit PCOS und Unfruchtbarkeit infolge einer Anovulation. Details der …
This study examined the effectiveness of insulin sensitors for ovulation induction in patients with polycystic ovarian syndrome (PCOS) and infertility. In the randomized, controlled clinical study, 120 patients were treated either with metformin or myo-inositol plus folic acid. The primary endpoint was the restoration of the spontaneous ovulation. Secondary endpoints were the resistance to the treatment, the pregnancy rate and the abortion rate. The results showed that myo-inositol had a statistically significant difference in the restoration of the spontaneous ovulation. Patients who received myo-inositol also showed a higher pregnancy rate. The authors recommend myo-inositol as a first-line treatment for patients with PCOS and infertility as a result of an amovulation. Details of ... (Symbolbild/natur.wiki)

This study examined the effectiveness of insulin sensitors to inducing ovulation in patients with polycystic ovarian syndrome (PCOS) and infertility. In the randomized, controlled clinical study, 120 patients were treated either with metformin or myo-inositol plus folic acid. The primary endpoint was the restoration of the spontaneous ovulation. Secondary endpoints were the resistance to the treatment, the pregnancy rate and the abortion rate. The results showed that myo-inositol had a statistically significant difference in the restoration of the spontaneous ovulation. Patients who received myo-inositol also showed a higher pregnancy rate. The authors recommend myo-inositol as a first-line treatment for patients with PCOS and infertility as a result of an removation.

Details of the study:

Reference

Raffone E, Rizzo P, Benedetto V. Insulinensitilizers alone and at the same time treatment with R-FSH for ovulation induction in PCOS women. gynecol endocrinol. 2010; 27 (4) 275-280.

Design

In this randomized, controlled clinical study, 120 patients with polycystic ovarian syndrome (PCOS) and 14–16 months of infertility were examined. The patients received either 1,500 mg metformin or 4 grams of myo-inositol plus 400 µg folic acid every day. In patients in whom there was pregnancy, an ovulation induction with a recombinant follicle-stimulating hormone (R-FSH) (37.5 units/day) was carried out for a maximum of 3 tests. The primary endpoint was the restoration of the spontaneous ovulation (measured by weekly monitoring of the serum professional level and transvaginal ultrasound for confirmation). The secondary endpoints were the resistance to the treatment (percentage of patients in which spontaneous ovulation was not restored), the pregnancy rate and the abortion rate.

The study showed a statistically significant difference in the restoration of the spontaneous ovulation in patients who take myo-inositol to metformin.

most important knowledge

In 50 % of the patients who received metformin, there was a spontaneous ovulation again, and 18.3 % of them achieved pregnancy. In 65 % of the patients treated with myo-inositol, there was a spontaneous ovulation again, and 30 % of them achieved pregnancy. R-FSH was additionally administered in the other patients who do not respond to monotherapy. In each of the two groups (Metformin Plus R-FSH group or myoinositol and folic acid plus R-FSH group) there were 11 pregnancies. The total pregnancy rates were 36.6 % in patients who received metformin, and 48.4 % in patients who received myo-inositol. The study showed a statistically significant difference in the restoration of spontaneous ovulation in patients who took myo-inositol to metformin. Overall, there was a higher pregnancy rate in the Myo-Inositol Group, but the effect was not significant.

effects on practice

A meter feature that is often observed in patients with PCOS is a defect in the inosite metabolism. Inositol plays an important role in insulin and glucose metabolism. Inositol accelerates the dephosphorylation of glycogen synthase and pyruvatdehydrogenase, both speed-determining enzymes of non-oxidative and oxidative glucose disposal. 1 The supply of myo-inositol can accelerate glucose utilization and sensitize the insulinity. This can reduce the hyperinsulinemic state, which can prevent proper secretion of the luteinizing hormone (LH).

Earlier studies have shown that myo-inositol can restore spontaneous ovarian activity and fertility in patients with PCOS. 3.4 This study is the first to compare the effectiveness of two insulin sensitis, inositol and metformin, in the treatment of chronic annovulation and infertility as a result of PCOS.

In this study, Myo-Inositol offered a significant advantage over Metformin when restoring spontaneous ovulation in patients with PCOS. This also led to a non -significant increase in the pregnancy rate. In addition, patients reported that myo-inositol income did not have any side effects in the course of treatment. Myo-Inositol should be considered as first-line treatment in patients with PCOS, in which chronic annovulation or infertility occurs as a result of an amovulation.