Declaration of Interests This work was prepared in part by a military employee of the US Government as part of official duties of T.S. and, therefore, is in the public domain and does not possess copyright protection. The opinions and assertions expressed herein are those of the author(s) and do not reflect the official policy or position of the Uniformed Services University of the Health Sciences or the Department of Defense. M.P.D. reports serving as a member of the Board of Directors and a stockholder of Advanced Reproductive Care; and serving as a Consultant for Seikagaku, Actamax, Temple Therapeutics, and ARC Medical Devices. R.W. reports Abiacare PCOS, Amgen Repatha in Pg, and Partners Mass General Menopause Reviews outside of the submitted work. R.L. reports consulting fees from InSupp, Ferring, Bayer, Abbvie and Fractyl and funding from UL1 TR002014 National Center for Advancing Translational Sciences, 5 R01AT009484-02 Inositol Supplementation to Treat Polycystic Ovary Syndrome: A Double-Blind Dose Ranging RCT (INSUPP-P) NIH/NCCIH, 5 R01 HD091350-04 The COMET-PCOS Trial: Comparing the effects of Oral Contraceptive Pills versus Metformin in the medical management of overweight/obese women with Polycystic Ovary SyndromeNIH/University of Pennsylvania, Guerbet USA Therapeutic Effect of Sonographic Hysterosalpingography: Oil vs. Water Based Media: The SHOW Pilot Trial, 5 R01 HD083323-04 Functional Analysis of PCOS Candidate Genes NIH/NICHD, 1 R01HD100630-01 AMH Signaling Pathway Variation in PCOS NIH, Hass Avocado Board A Multi-Site Randomized Clinical Trial to Compare Healthy Eating Recommendations for Six Months on Changes in Visceral Adiposity in Overweight/Obese Americans (Penn State Avocado Study), 5 U10HD055925-10REV Data Coordinator Center for the RMN; consulting fees from Organon, Covis Pharma GmbH (2022), Novo Nordisk (12/2021), and Insudd (2020); honorarium from Honorary Professor, National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan, China 2012-Present, Member, Steering Committee. Eastern Siberia PCOS Epidemiology & Phenotype study, Scientific Center of Family Health and Human Reproduction, Irkutsk, Russian Federation 2016-Present, Member, International Advisory Panel, Developing, disseminating, and implementing a core outcome set for infertility. Funded by the Royal Society of New Zealand Catalyst Fund and the University of Auckland, New Zealand, 2017-Present, Advisor, A metabolomic approach to redefine diagnostic criteria and classification of polycystic ovary syndrome (PI: Professor Chi Chui Wang, Chinese University of Hong Kong). Funded by the Research Fund, Food and Health Bureau, The Government of the Hong Kong Special Administrative Region. (There are no in-person meetings.); PCOS Challenge (patient support group) Member, Medical/Scientific Advisory Board, 2017-Present, Endocrine Society: Member Investment Subcommittee, 2018-Present; Associate Editor, Human Reproduction Update, 2017-2020, Associate Editor, Fertility and Sterility, 2009-2020, Editorial Editor, Fertility and Sterility, 2020-Present, Associate Editor, Global Reproductive Health, 2017-Present; Owner of 1000 shares of Biodesix (BDSX); NIH: ZHD1 DSR-K (LR) 1 Loan Repayment Program (Annually, 2008-Present), Special Emphasis Panel/Scientific Review Group 10 ZHD1 DSR-M (55): National Centers for Translational Research in Reproduction and Infertility (2020), Misc: Karolinska Institute, Stockholm, Sweden (2020) outside the submitted work. H.Z. reports NIH grants to the university for the submitted work. F.S. and S.L. have nothing to disclose. N.S. reports consulting for Ansh Labs, and is a Scientific Advisor to Astellas and Menogenix, Inc. and Astellas; Past President, Society for Reproductive Investigation, President, American Gynecologic Club.