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

Background and Objective: Polycystic ovary syndrome (PCOS) is the most prevalent endocrine disorder in women and a leading cause of infertility due to anovulation. This study aimed to evaluate the effects of inositol, metformin, and lifestyle modifications on fertility outcomes in women with PCOS undergoing assisted reproductive treatments (ART).Methods: This double-blind randomized clinical trial involved ۱۴۹ infertile women diagnosed with PCOS at the Molood Infertility Center in Zahedan, Iran, from July ۲۰۲۰ to December ۲۰۲۲, according to the Rotterdam criteria. The participants were randomized into three groups: metformin (Met) (۲۰۰۰ mg daily), myo-inositol (MI) (۲۰۰۰ mg daily), and a lifestyle modification (LM) group (۸۰۰ µg of folic acid and a weight loss diet). After three months, pregnancy outcomes were assessed using β-HCG testing and transvaginal ultrasound.Results: The average durations of marriage and infertility were ۷.۴۱ ± ۴.۹ years and ۵.۲۲ ± ۴.۰ years, respectively. The pregnancy rate in the metformin group was ۳۸% compared to ۳۲% in the inositol group and ۲۵% in the lifestyle modification group (p < ۰.۰۵). Furthermore, the live birth rate was significantly higher in the metformin group (۲۸%) compared to the inositol (۲۲%) and lifestyle modification groups (۱۵%) (p < ۰.۰۵). No significant correlations were found between age, BMI, marriage duration, and infertility duration among the groups.Conclusion: This study revealed that 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.

کلیدواژه ها:

Fertility ، Polycystic ovary syndrome (POS) ، Inositol ، Metformin ، Lifestyle modification ، Assisted reproductive treatments (ART)