Efektivitas Metformin dan Myo-Inositol terhadap Luaran Metabolik dan Reproduktif Pasien Polycystic Ovary Syndrome (PCOS)

Abstract

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder marked by ovulatory dysfunction, hyperandrogenism, and metabolic issues like insulin resistance. Metformin has long been used as an insulin-sensitizing agent in PCOS management; however, its limited tolerability and inconsistent effects on reproductive outcomes have encouraged the exploration of alternative therapies, including myo-inositol. This literature review aims to analyze the effectiveness of metformin and myo-inositol on metabolic and reproductive outcomes in patients with PCOS. The review was conducted through a systematic search of scientific articles in PubMed, Scopus, and ScienceDirect databases using keywords related to PCOS, metformin, myo-inositol, insulin resistance, menstrual cycle, ovulation, and androgen levels. Included studies were clinical studies published within the last ten years that met the predefined inclusion criteria. The findings indicate that both metformin and myo-inositol are effective in improving insulin resistance and metabolic parameters, although responses vary depending on body mass index and PCOS phenotype. Metformin appears to be more beneficial in PCOS patients with obesity and significant glycemic disturbances, whereas myo-inositol demonstrates better tolerability and benefits in certain reproductive outcomes, particularly in patients with normal body mass index and those undergoing assisted reproductive technologies. Several studies also suggest that combination therapy may offer additional benefits in selected patient groups, although it is not consistently superior to monotherapy. In conclusion, no single therapy is optimal for all PCOS patients; therefore, the choice between metformin and myo-inositol should be individualized based on the patient’s metabolic profile and clinical goals