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The Fertile Life · Episode 23
PCOS: a modern fertility strategy
Insulin, ovulation, weight, inositol, letrozole — what actually moves the needle for PCOS patients trying to conceive.
February 2026 41 minScience
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PCOSOvulation
Key takeaways
- 01
PCOS is a spectrum — not one disease, not one treatment.
- 02
Letrozole has overtaken Clomid as the first-line ovulation induction agent.
- 03
Inositol has real evidence behind it; not all supplements do.
- 04
Even modest weight changes can meaningfully restore ovulation.
Transcript
Dr. Ghadir
PCOS is one of the most misunderstood diagnoses in reproductive medicine. It's a spectrum. Two patients with the same diagnosis can have completely different bodies, completely different challenges, and completely different paths forward.
Dr. Ghadir
The throughline for most patients is insulin resistance. Addressing that — sometimes with metformin, sometimes with inositol, almost always with lifestyle work — opens the door to ovulation in a way no medication alone can.
Dr. Ghadir
Letrozole is now the first-line ovulation induction medication for PCOS. The data is clear. Higher live birth rates than Clomid, fewer multiples, and better tolerated.
Transcript edited for clarity. The audio is the authoritative source.
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