Hi Rach, I have PCOS too, and Metformin alone helped me (although I had already gone through a torturous 3 year path of tests, clomid, laparoscopy, ovarian drilling, IVF).

There are a number of theories on PCOS and also it is called a 'syndrome' as each woman experiences PCOS differently. As to fertility, well if you are not having periods, then you will have difficulty falling pregnant, although some women with PCOS do have regular periods and don't have fertility issues.

The things that are tried on PCOS women are: clomid (trying to stimulate ovulation), ovarian drilling (for some unknown reason injuring the ovaries can stimulate them to work properly), or hormone stimulation and IVF. Metformin is a drug used for diabetic patients, but it has been shown that at least half of women with PCOS have insulin resistance (a precursor to type II diabetes) and so Metformin may be given by your specialist to help you ovulate naturally. Metformin may also be used in conjunction with clomid (and if you are put on clomid, insist on going on Metformin as well as it has been proven that both work together better than clomid alone).

Unfortunately Metformin is controversial, with many docs not wanting to put patients on it who don't currently have diabetes or severe insulin resistance. I pressured my RE to put me on it, whilst taking a break from IVF and amazingly I fell pregnant.

Having had ovarian drilling, I would never recommend it (it may cause premature ovarian failure i.e. menopause and also the beneficial effects of drilling are temporary...I wish I'd known all this before I had it done).

My advice to you, speaking from experience, is to find a good RE (reproductive endocrinologist). Any old OB/GYN is NOT good enough, mostly they don't have the knowledge/experience with PCOS and are just happy to throw women on clomid without checking other fertiltiy issues (eg getting your DH's sperm checked, getting your tubes checked etc) and then the clomid may be a total waste (and it really knocks your body around).

Good luck! Hope I've been of some help.