Overall, ZSYTP combined with metformin hydrochloride significantly reduced BMI, increased insulin sensitivity, and improved TCM symptoms in infertile PCOS patients, consistent with findings reported by Naderpoor et al[26] and Oner and Muderris.[27] It is well recognized that obesity is closely associated with the development of PCOS. This evidence concerns the gene INS and obesity due to melanocortin 4 receptor deficiency.