Objective: To compare the efficacy of insulin sensitizer myoinositol versus a combination of myoinositol plus metformin for ovulation induction in polycystic ovarian syndrome.

Study Design: Prospective, randomize control trail.

Place & Duration of Study: Department of Obstetrics & Gynaecology, Sheikh Zayed Women Hospital Larkana from 1st January 2017 to 31st December 2017.

Methodology: Sixty patients were recruited. The proper clinical history, demographic and physical examinations were recorded. Sixty patient divided in two groups A and B, each group receive 30 patients. Group A received myoinositol 1 gm twice daily plus ovulation (letrozole +gonadotrophin) and Group B received two insulin sensitizer myoinositol and metformin plus ovulation induction protocol(from 2-6 days and 7-9 days. Transvaginal ultrasound performed on day 12 of all patients to see the follicular size.

Results: Mean age of participants was 26.4±4.4 years and LH/FSH ratio was >1.5. Oligomenorrhea, infertility, hirsutism, and overweight were the major clinical manifestation of women with PCOs. Twenty nine women with PCOs of group A (metformin plus myoinositol) were increased number of follicles as compared to women of group B (myoinositol alone), the difference was statistically significant (p<0.05).

Conclusion: The combination of these two drugs ‘Metformin and Myoinositol’, work synergistically that gives more metabolic and reproductive benefits as compared to single drug work alone.

Keywords: Polycystic ovarian syndrome, Ovulation, Metformin, Myoinositol, Insulin sensitivity