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this finding is consistent with that of another study, that is, the activation of the MAPK pathway (e.g., ERK1/2 activation) is involved in ER stress, cell proliferation, cell cycle arrest, and autophagy 38

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115 , 116 Similarly, in 150 women with infertility and letrozole resistance, threemonth treatment with either metformin (1500 mg/day) or inositol, both with folic acid, showed no significant effect on ovarian function or pregnancy rate compared with folic acid alone, though inositol was more effective than metformin in women with normal BMI

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