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Background: Polycystic ovarian syndrome is considered to be a multifaceted disease with a spectrum of manifestation affecting not only women of childbearing age group but also adolescent and post-menopausal women. Most prevalence studies in India prevalence of PCOS as 3.7%-22.5%. Rotterdam consensus conferences, revised diagnostics criteria used. Treatment depends on patient goals ranging from lifestyle modification to drug therapy. It includes: dietary and lifestyle modification, medical management with oral contraceptive pills, metformin, spironolactone, ovulation induction with letrozole, clomiphene. Methods: Study was conducted in women of reproductive age group with PCOS attending gynaecological OPD at RNT medical college Udaipur. It is a prospective comparative study. Total 290 women included and were followed up for one year. Results: One year follow up among letrozole group 9 women got conceived, among metformin with letrozole group 23 women got conceived which was statistically significant. Metformin group had significantly greater difference followed by OCP+Metformin group and lifestyle modification group. OCP group and OCP+Metformin group has significant reduction in incidence of hirsutism at one year follow-up. OCP group and OCP+Metformin group had significant reduction in acne at one year follow-up. Conclusions: Weight reduction is better after metformin along with lifestyle modification than lifestyle modification alone or combine OCP with metformin treatment. Hyperandrogenic symptoms are better responded with OCP then other mode of treatment. Menstrual regularity is well attained by combination treatment of OCP and metformin then monotherapy. Combination of letrozole and metformin is superior as compared to letrozole alone for induction of pregnancy.
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