<s>[INST] Madam, I am Smitha, married last yr ( now 1yr) . For 6 months we are in planning. But now we want a baby. My height is 150 cm. weight 78.  US report PCOD. FSH, LH, Prolactin, TSH are normal. Now Metformin tablet is used regularly. One Dr. prescribed siphene 50 mg. is it good for me? [/INST] Dear Smitha, Polycystic Ovarian Syndrome (PCOS) is a condition which is characterised by infertility due to non release of the eggs (anovulation) from ovaries. Along with, there are high levels of Insulin and Androgens. Siphene contains Clomiphene citrate as an active medicine. This medicine helps inducing ovulation. Since the Insulin levels are high, adding Metformin helps success to Clomiphene citrate by reducing Insulin. There is another view that Myo inositol reduces both the Insulin and androgen levels and hence has better success than Metformin. Clomiphene citrate should be tried for not more than 6 cycles. If it fails, then some other medicines like HMG/hCG combination should be tried. You seem to be rather obese. Obesity also is a classic feature of PCOS. Please modify your diet (high protein, low fat and low carbohydrates) and start daily exercises to bring down your BMI between 18 and 23.9. All your other reports are within normal limits. However, please get your husband's semen also tested in a laboratory. I hope this provides you some guidelines based on your brief history. Dr. Nishikant Shrotri </s>