Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-aged women, with a prevalence between 10 to 13%. PCOS has a large component of Insulin Resistance at its core. This is not only a metabolic complication in gynecology, but also has adverse implications for pregnancy. Since metformin is a staple of PCOS care, not only for infertility but also for the metabolic syndrome in adults, a common question is what to do with that medication once conception occurs. Should metformin continue past conception, and if so...should it be stopped at a certain gestational age or continued until delivery. There is data to help with this clinical conundrum. In this episode we will review the data from 2001 up to the most recent ASRM PCOS management guideline for PCOS, which just came out-ahead of print- last month August 2023.