Which medication is used to re-establish ovulation in PCOS-related infertility?

Which medication is used to re-establish ovulation in PCOS-related infertility?

• A. Metformin alone.
• B. Leuprolide.
• C. Finasteride.
• D. Clomiphene.

Answer: (D)

Inducing ovulation in PCOS relies on triggering the hypothalamic-pituitary-ovarian axis to resume regular follicle development. Clomiphene citrate does this most reliably. It acts as a selective estrogen receptor modulator in the hypothalamus, blocking estrogen’s normal negative feedback. That simulates a state of low estrogen, prompting increased GnRH release, which then raises FSH and LH from the pituitary. The surge of FSH drives follicular growth and ultimately ovulation. Metformin can improve insulin resistance and may help restore ovulation in some women with PCOS, especially if there’s metabolic dysfunction, but it’s not as consistently ovulation-inducing as clomiphene when used alone. Leuprolide is a GnRH agonist used in controlled ovarian stimulation scenarios such as certain IVF protocols, not as a first-line agent for PCOS-related infertility. Finasteride targets androgenic symptoms, not ovulation. So the best option to re-establish ovulation in PCOS-related infertility is clomiphene citrate.

Inducing ovulation in PCOS relies on triggering the hypothalamic-pituitary-ovarian axis to resume regular follicle development. Clomiphene citrate does this most reliably. It acts as a selective estrogen receptor modulator in the hypothalamus, blocking estrogen’s normal negative feedback. That simulates a state of low estrogen, prompting increased GnRH release, which then raises FSH and LH from the pituitary. The surge of FSH drives follicular growth and ultimately ovulation.

Metformin can improve insulin resistance and may help restore ovulation in some women with PCOS, especially if there’s metabolic dysfunction, but it’s not as consistently ovulation-inducing as clomiphene when used alone. Leuprolide is a GnRH agonist used in controlled ovarian stimulation scenarios such as certain IVF protocols, not as a first-line agent for PCOS-related infertility. Finasteride targets androgenic symptoms, not ovulation.

So the best option to re-establish ovulation in PCOS-related infertility is clomiphene citrate.