Combination Letrozole and Clomiphene Citrate Versus Letrozole Alone

This study compares two treatments for inducing ovulation in women with polycystic ovary syndrome (PCOS) who are struggling to get pregnant: letrozole alone versus a combination of letrozole and clomiphene citrate (two different fertility medications). The goal is to find out if the combination leads to higher pregnancy rates. **You may be eligible if...** - You have been diagnosed with PCOS based on standard criteria (irregular periods, excess androgens, or polycystic ovaries on ultrasound) - You have been unable to get pregnant after 12 months of trying (or 6 months if over 35) - Your fallopian tubes are open and your partner has a normal semen analysis - You are capable of participating in the study **You may NOT be eligible if...** - You have unexplained infertility (another cause, not PCOS) - You have other causes of irregular ovulation (thyroid problems, high prolactin, Cushing's syndrome, adrenal problems) - You have endometrial hyperplasia or cancer - You are allergic to or cannot take letrozole or clomiphene - You have uncontrolled diabetes or high blood pressure Talk to your doctor to see if this trial is right for you.