Insulin Sensitizers Role in Control of PCOS Vicious Cycle.

Inclusion Criteria: * Age; * Residence; * level of education \& type of work; * Marital and fertility statuses, and if infertility was the main complaint; * Presence of risk factors as sedentary lifestyle; * Emotional stress and family history of PCOS; * Obesity-related medical disorders especially DM or MAFLD; * History of previous treatment for PCOS and its outcomes; * Menstrual pattern such as infrequent menstrual periods. Exclusion Criteria: * Women had other manifestations of metabolic syndrome: * Cardiac manifestations of PCOS; * Maintained on other therapies or prepared for /received laparoscopic intervention for PCOS; * Receiving scheduled exercise, lipid-lowering therapies, or maintained on diabetogenic drugs for any other indications; * Had morbid obesity with body mass index (BMI) \>35 kg/m2; * Causes other than PCOS for infertility, manifest DM, hepatic or pancreatic diseases.