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A meta-analysis of randomized trials has demonstrated that metformin lowers the incidence of miscarriage (RR = 0.86, 95% CI: 0.671.12), preeclampsia (RR = 0.45, 95% CI: 0.240.83), and preterm delivery (RR = 0.37, 95% CI: 0.230.61) in PCOS patients (Moghetti et al., 2000

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NICE recommends lifestyle modifications and PDE5 inhibitors such as sildenafil, tadalafil, vardenafil, and avanafil as first-line pharmacological treatments

They may also be helpful for people whose diets have changed significantly, especially if they are eating fewer animal-based foods or following a reduced-calorie plan that limits certain nutrients