INS and polycystic ovary syndrome: While metformin and other insulin sensitizing drugs such as myo-inositol has been shown to be effective in increasing ovulation rates in in some women with PCOS (33), a large triple-arm RCT (40) of 626 women with PCOS comparing fertility outcomes between metformin with placebo, clomiphene with placebo, and combined treatment of clomiphene with metformin, concluded that clomiphene is superior to metformin in achieving live birth in infertile women with PCOS (40).