1, obesity and insulin resistance Increase exercise to reduce body weight, correct the endocrine metabolic disorders aggravated by obesity, reduce insulin resistance and hyperinsulinemia, so that IGF-1 is reduced, IGfBP-1 increases, while SHBG increases so that the free androgen level decreases. Weight loss can restore ovulation in some obese PCOS patients, and prevent the occurrence of type 2 diabetes and cardiovascular disease. Metformin 1.5-2.5g/d with or without diabetes can be used to effectively reduce body weight, improve insulin sensitivity, lower insulin levels, reduce hairiness and even restore menstruation and ovulation. Since obesity and insulin resistance are the main causes of PCOS, any drug that can reduce body weight and increase insulin sensitivity can be used to treat this syndrome. In recent years, there have been many reports on the treatment of insulin sensitizers. Thiazolidinedione is a class of oral insulin sensitizers, mainly used for the treatment of diabetes, such as troglitazone can significantly reduce hyperinsulinemia and hyperandrogenemia in PCOS patients, and help induce ovulation. 2, drug-induced ovulation (1) Clomiphene: is the drug of choice for PCOS, with an ovulation rate of 60%-80% and a pregnancy rate of 30%-50%. Clomiphene competes with endogenous estrogen at the hypothalamic-pituitary level for receptors, inhibits negative estrogen feedback, increases the pulse frequency of GnRH secretion, and thus adjusts the ratio of LH to FSH secretion. Clomiphene also directly induces estrogen synthesis and secretion by the ovaries. Clomiphene is administered orally at 50 mg daily for 5 consecutive courses starting on day 5 of the natural menstrual cycle or withdrawal uterine bleeding. If ovulation does not occur after 3 treatment cycles, the dose can be increased to 100-150mg per day and the starting dosage can be reduced in lighter weight patients. After taking this drug, side effects such as ovarian enlargement due to overstimulation, vasodilation with bouts of heat, abdominal discomfort, blurred vision or rash and mild hair loss may occur. (2) Combination of clomiphene and chlortetracycline: add chlortetracycline 2000-5000U intramuscularly on day 7 after discontinuation of clomiphene. (3) Combination of glucocorticoids and clomiphene: The effect of adrenocorticosteroids is based on their ability to suppress the excess androgens secreted from the ovaries or adrenal glands. Dexamethasone or prednisone is usually used. Prednisone at 7.5-10 mg daily was 35.7% effective over 2 months, with some restoration of ovarian function in amenorrhea without ovulation. When ovulation induction with clomiphene is ineffective, dexamethasone 0.5mg can be added to the treatment cycle at the same time, and 2.0mg per night for 10 days to improve.