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29), lower AND (WMD -2.70, 95% CrI -3.91 to -1.5 and lower FG (WMD -0.41, 95% CrI -0.73 to -0.08). Conclusion For overweight women with PCOS, both metformin combined with GLP-1 receptor agonists and metformin combined with TZDs appear superior to monotherapy in improving hyperandrogenemia. Metformin combined with TZDs could be particularly effective in promoting the recovery of menstruation. Metformin combined with GLP-1 receptor agonists has additional advantage in improving fasting glucose when compared with GLP-1 receptor agonists