The present study recruited 140 women with anovulatory PCOS presenting with Clomiphene citrate resistant PCOS, among those attending infertility OPD in our tertiary care hospital, Chennai, India. The study period is from April 2021 to March 2022, for a period of 12 months .Patients were counselled regarding oral medications and gonadotropin injections and divided into Group 1 and Group 2. Group 1 patients received Aromatase inhibitor Letrozole 5mg orallyfrom day 2 or day 3 of menstrual cycle for 5 days, following spontaneous or progesterone induced menstrual cycle. Group 2 patients received Human Menopauasal gonadotropin in a modified step up protocol as 75 IU IM 3 doses on day 3, day 5 and day 7(alternate days). Day 2 LH and Sr. Prolactin was measured for all the patients . The study was approved by the ethics committee of the hospital and written informed consent obtained from all the patients. Tubal patency ensured on atleast one side by HSG or SIS under transvaginal B mode ultrasound, with normal uterine cavity. Semen analysis of the male partner was ensured to be normal, to include the patient in the study