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The Experts Recommendation
Infertile PCOS
Obese Nonobese
Lifestyle therapy Clomiphene Clomiphene
Hum Reprod. 2008 Mar;23(3):462-77 and Fertil Steril. 2008 Mar;89(3):505-22
Infertility in PCOS: Lessons from
0.5
0.4
0.3 0.2 0.1
0.0 150
P-value: <0.001
Clomiphene Metformin Combined
200 250 300
350 400
450 500
Days from Randomization to Live Birth
Legro et al, NEJM 2007
PPCOS I
 Clomiphene superior to metformin
 Clomiphene resistance: 25% never ovulated once in up to 6 treatment cycles
 Clomiphene Failure Common: 78% did not have a baby
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