The Effect of Inositol, Metformin, and Lifestyle Modification on Fertility Outcomes in Patients with Polycystic Ovary Syndrome Undergoing Assisted Reproductive Treatment

Background & Objective: Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrine disorder in women and a leading cause of infertility due to anovulation. This study was conducted with aim to evaluate the effects of inositol, metformin, and lifestyle modifications on fertility outcomes in women with PCOS undergoing Assisted Reproductive Treatments (ART).Materials & Methods: This double-blind randomized clinical trial was conducted on 149 infertile women diagnosed with PCOS according to the Rotterdam criteria at Molood Infertility Center in Zahedan, Iran, from July 2020 to December 2022. The participants were randomized into three groups: Metformin (Met) (2000 mg daily), Myo-Inositol (MI) (2000 mg daily), and Lifestyle Modification (LM) (800 µg of folic acid and a weight loss diet). After three months, pregnancy outcomes were assessed using β-HCG testing and transvaginal ultrasound. P<0.05 was considered statistically significant.Results: The mean durations of marriage and infertility were 7.41±4.9 years and 5.22±4.0 years, respectively. The pregnancy rate in the metformin group was 38% compared to 32% in the inositol group and 25% in the lifestyle modification group (P<0.05). Furthermore, the live birth rate was significantly higher in the metformin group (28%) compared to the inositol (22%) and lifestyle modification groups (15%) (P<0.05). No significant correlations were found between age, BMI, marriage duration, and infertility duration among the three groups.Conclusion: Both metformin and inositol may improve fertility outcomes in women with PCOS undergoing assisted reproductive treatments, with metformin showing superior efficacy in terms of pregnancy and live birth rates.