Efficacy of L-Arginine, Myoinositol, and Chromium with Letrozole for Ovulation Induction in Polycystic Ovarian Syndrome: A Randomized Comparative Study.

BACKGROUND

PCOS is a hormonal disorder with no medication, hence treatment is symptomatic. Letrozole plus chromium, L-arginine, or myoinositol was tested in PCOS-infertile women.

METHODS

This prospective trial randomly assigned 240 PCOS patients (n = 60) to one of four groups: letrozole + chromium, L-arginine, myoinositol, or the control. Insulin resistance, testosterone, HOMA-IR, hirsutism, DHEA, and ovulatory function were examined before and after treatment.

RESULTS

At each follow-up, all groups showed substantially different ovulation rates (p = 0.026, 0.039, and 0.008 at 1, 2, and 3 months, respectively). Weight, HOMA-IR, and hirsutism were decreased with chromium and myoinositol (p = 0.001). Chromium, myoinositol, and L-arginine significantly reduced testosterone. Myoinositol had the highest pregnancy rates at one and two months (36.7% and 41.9%, respectively).

Conclusion

letrozole combined with chromium or myoinositol improves PCOS ovulation, HOMA-IR, and hirsutism.