Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Eur Rev Med Pharmacol Sci. 2021 Apr;25(7):3105-3115. doi: 10.26355/eurrev_202104_25565.
Recent studies have revealed that myo-inositol could be more influential in patients with polycystic ovary syndrome (PCOS). This study was aimed to determine and compare the effects of myo-inositol and metformin on hormonal and metabolic profiles and fertility outcomes.
A comprehensive search was carried out among the English-language databases, including PubMed, Scopus, Cochrane Library, Google Scholar, and Web of Science, and the articles published from April 2010 to February 2019 were tracked down. The fixed and random-effects meta-analysis was used to estimate the pooled effect size. The meta-analysis was performed in Stata Version 14.0.
Nine studies with 331 patients treated with metformin and 307 patients treated with myo-inositol groups were included in the analysis. The research groups did not diverge significantly in terms of the basic characteristics, such as age and Body Mass Index (BMI). In the myo-inositol group, the levels of Luteinizing Hormone (LH) [12.55% (95% I: 11.41-13.68%)], S. testosterone [44.38% (95% CI: 38.09-50.67%)] and prolactin [7.97% (95% CI: 6.58- 9.37%)] were significantly higher than those recorded, i.e., LH [7.97% (95% CI: 6.58- 9.37%)], S. testosterone [8.48% (95% CI: 3.14-13.83%)] and prolactin [7.14% (95% CI: 1.50-14.79%)] for the metformin group (p<0.001).
Due to the dearth of related research and the high heterogeneity of the Randomized Clinical Trials (RCTs) included in other studies, the present systematic review could not establish any differences between metformin and myo-inositol concerning the hormonal profile and the ovarian function. However, the findings indicated that myo-inositol could improve fertility outcomes by modulating hyperandrogenism. Randomized trials are required to understand the mechanistic actions of myo-inositol in comparison with those of metformin regarding oocyte and embryo quality, fertilization, pregnancy, and live birth rates.
最近的研究表明，肌醇对多囊卵巢综合征（PCOS）患者的影响可能更大。本研究旨在确定和比较肌醇和二甲双胍对激素和代谢谱以及生育结局的影响。
在包括 PubMed、Scopus、Cochrane 图书馆、谷歌学术和 Web of Science 在内的英文数据库中进行了全面检索，并追踪了 2010 年 4 月至 2019 年 2 月发表的文章。使用固定效应和随机效应荟萃分析来估计汇总效应大小。荟萃分析在 Stata 版本 14.0 中进行。
纳入了 9 项研究，其中 331 例患者接受二甲双胍治疗，307 例患者接受肌醇治疗。研究组在年龄和体重指数（BMI）等基本特征方面没有明显差异。在肌醇组中，黄体生成素（LH）水平[12.55%（95%可信区间：11.41-13.68%）]、血清睾酮[44.38%（95%可信区间：38.09-50.67%）]和催乳素[7.97%（95%可信区间：6.58-9.37%）]明显高于二甲双胍组记录的 LH [7.97%（95%可信区间：6.58-9.37%）]、血清睾酮[8.48%（95%可信区间：3.14-13.83%）]和催乳素[7.14%（95%可信区间：1.50-14.79%）]（p<0.001）。
由于相关研究的缺乏以及其他研究中随机对照试验（RCTs）的高度异质性，本系统评价无法确定二甲双胍和肌醇在激素谱和卵巢功能方面的差异。然而，研究结果表明，肌醇可以通过调节高雄激素血症来改善生育结局。需要进行随机试验来了解肌醇与二甲双胍在卵母细胞和胚胎质量、受精、妊娠和活产率方面的作用机制。
