Publication:

Comparison of effects of metformin and inositol on AMH levels in PCOS patients

Background PCOS is very common problem. Insulin resistance is an integral part of PCOS. AMH level in women with PCOS are 2-3 times higher than in healthy women. In PCOS patients, there is excess amount of AMH and its physiological effect lasts longer than it should in larger follicles, leads to arrest of dominant follicle selection.

Methods It was a prospective, interventional randomized clinical trial, a single tertiary center study over a period of 8 months. Cases with the documented PCOS were taken into account and divided into 2 groups, group A and group B randomly by alternate assigning of patients. Group A was given metformin and group B was given inositol. Group A was given metformin 850 mg twice daily orally and group B was given myo-inositol 1100 mg +D chiro inositol 27.6 mg plus 100 pg folic acid once daily for 12 weeks.

Results AMH levels were reassessed after 12 weeks of period and changes in the levels of AMH were compared. In metformin group total number of patients were 86 of which 84 patients (97.7%) showed decrease in AMH levels while 2 patients (2.33%) did not show any changes. In inositol group total number of patients were 87 of which 53 patients (60.91%) showed decrease in AMH levels while 34 patients (39.1%) did not show any changes. There was a significant difference between the groups in terms of distribution of decrease in AMH (χ2=35.454, p<0.001).

Conclusions As compared to Inositol group there were more patients who had decrease in AMH levels in metformin group. Hence, metformin is better than inositol in decreasing AMH levels in PCOS patients.