The polycystic ovary syndrome (PCOS) is a major health problem that affects 5-10% of women of childbearing age. PCOS is characterized by hyperandrogenism and anovulation, and is the primary cause of female infertility in the United States. Despite its importance as a health problem, the treatment of PCOS has changed little in the past thirty years. It is now recognized that insulin resistance, accompanied by hyperinsulinemia, is a central feature of PCOS which has led to heightened interest in the use of insulin "sensitizing" agents for the management of this condition. D-chiroinositol is a unique insulin sensitizing agent that acts by restoring depleted intracellular components of the inositol glycan signal transduction system in insulin sensitive tissue. Evidence suggests an important role for the inositol glycan signalling system in human ovaries. Our hypothesis is the D-chiroinositol will improve the insulin resistance associated with PCOS and reduce androgen excess and improve ovulation in affected subjects. Studies will be conducted in both obese and lean PCOS subjects and information gathered regarding the pharmacological properties of this agent. These studies will lead to the development of a novel approach to the management of PCOS by correcting an underlying defect in insulin action. PROPOSED COMMERCIAL APPLICATION: Development of a therapeutic approach for the clinical management of polycystic ovary syndrome.