DOI -10.21276/obgyn.2019.5.2.2 ISSN Print – 2454-2334; ISSN Online – 2454-2342 A comprehensive overview of role of combined myoinositol and D-chiroinositol (40:1 ratio) therapy in the management of PCOS Abhijeet G Malvi, Alok Chaturvedi, Sonal V Mehta, Kishore R Sonkusare, Nilanj S Dave Correspondence: Dr Abhijeet G Malvi, Senior Manager, Medical Affairs, Intas Pharmaceuticals Ltd, Ahmedabad, Gujrat, India; Email – abhijeet_malvi@intaspharma.com Distributed under Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) ABSTRACT Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive ailment among reproductive age group women. PCOS patients present with a constellation of signs and symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts quality of life. Women with PCOS is at increased risk of various morbidities, which includes obesity, insulin resistance, type II diabetes mellitus, cardiovascular disease (CVD), infertility, cancer, and psychological disorders. Exact pathophysiology of PCOS is poorly understood although studies have suggested an important role of insulin resistance and/or resultant compensatory hyperinsulinemia. Deficiency in the usage and/or tissue availability of myoinositol (MI) and/or D- chiroinositol (DCI) in PCOS patients could likely lead to insulin resistance typical of this syndrome. Recent studies have demonstrated that combined supplement containing both MI + DCI in their physiological plasma ratio 40:1 is able to improve the endocrine profile, ovarian function and the insulin resistance in PCOS patients. The aim of the present review was to summarize currently available data on the MI+DCI (40:1) combination therapy in PCOS patients. Keywords: Polycystic ovary syndrome, myoinositol, D-chiroinositol, insulin resistance. In modern medical era, polycystic ovary syndrome (PCOS) was first described by Stein and Leventhal in 1935, who studied seven females with amenorrhea, hirsutism and enlarged ovaries with multiple cysts. 1 PCOS is now recognized as a common, heterogeneous, heritable disease affecting females throughout their lifetime. It is most common cause of hyperandrogenism and oligo/anovulation leading to notable psychological, social, and financial consequences. 2 The prevalence of PCOS has shown significant rise from 8% to almost 20% globally within the past two decades. 3 Studies conducted on PCOS in India showed a prevalence ranging from 3.7 % to 22.5 % 4,5 (with 9 % to 36% prevalence in adolescents). 6,7 In Indian subcontinent, PCOS prevalence rate amongst infertile women is high (upto 50-60 %). 8 Clinical symptoms and conditions associated with polycystic ovary syndrome 9, 10 (Figure 1) As per Rotterdam criteria which is widely followed REVIEW ARTICLE Received: 28 th September 2018. Accepted: 26 th December 2018. Malvi AG, Chaturvedi A, Mehta SV, Sonkusare KR, Dave NS. A comprehensive overview of role of combined myoinositol and D-chiroinositol (40:1 ratio) therapy in the management of PCOS. The New Indian Journal of OBGYN. 2019; 5(2):71-8