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Also, given the observational nature of the study, we could expect the presence of indication bias, a type of confounding bias that occurs when a symptom or sign of disease is judged as an indication for a given therapy, and is therefore associated both with the use of a drug and with a higher probability of an outcome related to the disease for which the agent is indicated [37]

It has long been understood that PCOS, as a disorder, is much more than just pathological ovarian cysts and in fact encompasses diverse endocrine and metabolic features and that these features contribute to delayed definitive diagnosis and a resulting fragmentation in delivery of care

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