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    Subjects/OBG/PCOD — Clinical
    PCOD — Clinical
    medium
    baby OBG

    A 32-year-old woman with PCOD (confirmed on ultrasound and elevated LH:FSH ratio) presents with secondary infertility of 2 years. She has been on metformin 1000 mg twice daily and lifestyle modification for 6 months. Menstrual cycles remain irregular (50–70 days). Baseline FSH is 6 mIU/mL and LH is 18 mIU/mL. She has no other medical comorbidities. What is the most appropriate next step in management?

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