This chapter addresses issue of infertility starting with the case history, examination, and investigations. Pertinent questions related to the issue are given in this chapter along with their crisp and to the point answers. Initial baseline investigations that need to be ordered in this case are pregnancy test, blood tests, transvaginal scan, thyroid abnormalities, prolactin levels, HbA1c, and transvaginal scan. A transvaginal ultrasound is required to confirm or rule out polycystic ovarian (PCO) morphology pattern. Weight loss is recommended as the first line of therapy in women with PCOS. Loss of even 5% of the initial body weight is associated with spontaneous ovulation, often resulting in pregnancies. Counseling women regarding the importance of weight loss is essential. Diet and exercise are the common recommendations. Clomiphene citrate (CC) is the treatment of first choice for ovulation induction in women with PCOS. The starting dose of CC is traditionally 50 mg daily for 5 days, starting either on day 2 or day 5 of the menstrual cycles. Multiple ovarian puncture using diathermy or laser is known as ovarian drilling. Tissue destruction leads to reduction in androgen and LH levels. However, ovarian drilling should not be excessive (not more than 4–6 points) and must be away from the vascular supply of the ovaries. Insulin resistance and hyperinsulinemia are common features for both lean and obese women with PCOS. Target cells fail to respond to ordinary circulating levels of insulin.