Objectives: There is limited evidence that giving Vitamin D supplementation had a beneficial effect on insulin resistance and dysfunction of the menstrual cycle in females with polycystic ovary syndrome (PCOS). Thus, the aim of the present study is to evaluate the effect of Vitamin D supplementation on insulin sensitivity and androgen level in Iraqi females with PCOS. Methods:A randomized, blinded clinical trial design studied 60 Iraqi females with PCOS referring to the women's counseling, outpatients at maternity and pediatrics teaching hospital in AL-Qadisiyah city, Iraq, and private clinic. Non-probabilistic sampling involved women aged from 18 to 45 years established on inclusion criteria. The patients' basic data have been recorded. Then, we measured Vitamin D, testosterone level, and impaired glucose tolerance (IGT) test to all females. After the diagnosis of Vitamin D deficiency, Vitamin D was administering at 5000 units daily for 8 weeks. All data were remeasured after 2 months.Result: A total of 60 patients with polycystic syndrome enrolled in the study, age range from 18 to 39 years, mean age 27.48±5.95 years. The metabolic parameter have been checked at the beginning of the study, which include Vitamin D level 16.1±5.6, impaired glucose test reading 8.8±0.7 and testosterone level 4.5±0.64.. After 2 months of supplementation, there were 83.7% of patients reach the normal level of Vitamin D and 16.3% still had a low level of Vitamin D (p≤0.002) between two groups. In regard to IGT test after 2 months of supplementation, there were 51.6% of patients still who had impaired test while 48.4% reach the normal reading (p≤0.001). Conclusions:Women with PCOS have a statically significant low level of Vitamin D in mean, IGT test in the mean, and high level of testosterone, and there were inverse correlations between Vitamin D with IGT and testosterone.

Polycystic ovary syndrome (PCOS) is characterized by menstrual irregularities, high androgen levels, and ovarian cysts. Clomiphene citrate (Clomid) and letrozole have both been investigated as ovulation induction therapies for PCOS. This interventional study aimed to compare the efficacy and safety of a stairstep practice of letrozole versus clomiphene citrate in women with PCOS. A total of 100 women diagnosed with PCOS and infertility participated in the study, which took place from March 2021 to July 2022 at the Maternity and Children Teaching Hospital in Adiwaniyah Province, Iraq. Participants were randomly assigned to one of two groups (each with 50 women): the first group received clomiphene citrate in a stair step pattern (single dose of 50 mg, 100 mg, and 150 mg) for five days, for a maximum of three cycles; the second group received letrozole in a stair step pattern (single dose of 2.5, 5, and 7.5 mg) for five days, for a maximum of three cycles. Follicle size was monitored using ultrasound to achieve a follicle size >18 mm. The ovulation rate was higher in the letrozole group (86.0%) compared to the clomiphene citrate group (72.0%), although the difference was not statistically significant (p=0.086). The pregnancy rate was slightly higher in the letrozole group (22.0% vs 18.0%), but also not statistically significant (p=0.617). However, the mean time from menstruation to ovulation was significantly shorter in the letrozole group (17.20±1.32 days) compared to the clomiphene citrate group (24.08 ± 1.56 days, p<0.001). There were no significant differences in common side effects between the two groups. Overall, letrozole was found to be as safe as clomiphene citrate but demonstrated a shorter time to ovulation. Further studies with larger sample sizes are necessary to validate these findings and determine their clinical implications.