USED INOSITOL DECREASED Anti-Müllerian Hormone (AMH) IN POLY CYSTIC OVARY SYNDROME WOMEN

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia, In PCOS, several of the physiological events within the ovarian cycle and folliculogenesis are disrupted. The very beginning of folliculogenesis is compromised due to high levels of Anti-Müllerian Hormone (AMH)]( L. Pellattet al .,2010). In women with PCOS, elevated levels of AMH appear to play an important role in long term disruption of ovarian physiology [A. Karkanaki et al .,2011], with greater AMH concentrations being linked to worse fertility outcomes [A. Pierre et al .,2013]. in women with PCOS advocate for a more complex role of leptin in its pathophysiology. Moreover, reports of elevated leptin in nonobese PCOS patients further question quantitative adiposity as the sole origin of hyperleptinemia in this scenario [R. Yildizhan et al .,2011]. Regardless of its origin, in PCOS hyperleptinemia exerts direct effects on ovarian physiology by arresting follicle development. material and method The study group which complete study period included (95) PCOS women(group A) include (35) women will treated with Metoformine for six months and (group B) include (32) women will treated with Choline &Inositol and Metoformine for six months and (group C) include (28) women will changed lifestyle and followed deit for six months we massacred AMH,Lep and BMI ,before and after treatment by using ELISA . RESULT highly significant decrease (p<0.01)in BMI in group B while non significant in group A and C.,significant decrease (p<0.05)in Lep level in group( B, C) while non significant in group A.,significant decrease in AMH level in group (A,B)while non significant in group C. Conclusions used cholin & inositol plus metformin could be as a first- line treatment in patients with PCOS.