A stepwise approach in the management of infertility in women with PCOS will result in pregnancy and live birth in most cases. First goal should be lifestyle modification, we should aim to help and guide the patient with changing diet and practicing regular exercise in attempt to lose weight. Next step in these patients would the administration of orally taken agents like CC or letrozole, with recent studies showing a promising future in the shift of first line treatment favoring letrozole over CC Metformin has an important role in management of women with insulin resistance and in weight reduction, and is becoming more and more common as an adjacent drug in ovulation induction as part of different treatment protocols. 2nd line treatment consist of wither Gonadotropins and LOD, with the former preferred because its equally effective and less invasive. Last resort for the patients who didn't respond to any of these options is IVF.