Polycystic Ovary Syndrome is a prevalent endocrine disorder affecting women of reproductive age, characterized by a combination of clinical, hormonal, and metabolic abnormalities, including hyperandrogenism, ovulatory dysfunction, and insulin resistance.

 Metformin, an insulin-sensitizing drug has been shown to improve insulin resistance, reduce androgen levels, and promote ovulation in women with PCOS. Despite its efficacy, metformin is associated with gastrointestinal side effects, leading to the exploration of alternative therapies

Myo-inositol and D-chiro-inositol, naturally occurring compounds involved in insulin signaling, have emerged as promising alternatives to metformin. These inositols, particularly when used in combination, are thought to improve insulin sensitivity, restore hormonal balance, and regulate menstrual cycles in women with PCOS . Several studies suggest that the combination of MI and DCI can positively influence the metabolic and reproductive profiles of PCOS patients, with fewer side effects compared to pharmacological treatments like metformin.

However, direct comparisons between metformin and the MI/DCI combination are limited. Most of the studies are not randomized with few sample size or having heterogeneous population. This study aims to fill this gap by comparing the effects of metformin and MI/DCI on the clinical, hormonal, and metabolic profiles of women with PCOS, providing crucial data to guide more effective and tolerable treatment options.

In infertility clinic and OPD, after diagnosis of PCOS and informed consent baseline investigations like clinical, metabolic and hormonal parameters are done along with baseline TVS scan and PCOSQOL scale. Patients will be randomized to either the interventional group or the control group . Study group will be treated with myoinositol and d-chiro inositol 2255 mg OD for 3 months. The control group will be treated with metformin 500 mg BD for 3 months. Subjects will be called for follow up  visits at 4 weeks, 8 weeks and 12 weeks. At Every follow up visit, counselling sessions, adherence and side effects are noted.  After the last visit  all parameters- clinical, metabolic and hormonal will be checked and quality of life using PCOSQOL scale will be assessed.