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Research by Dhillo, Jayasena, and Comninos at Imperial College London has established that kisspeptin signaling is dysregulated in PCOS, and that administering exogenous kisspeptin can trigger coordinated LH surges in women with the condition.[8] A phase 2 trial demonstrated that subcutaneous kisspeptin administration successfully triggered ovulation in a proportion of women with PCOS who had not responded to conventional ovulation induction, including clomiphene citrate.[9] This is a genuinely novel therapeutic signal kisspeptin addresses a mechanism that metformin, combined oral contraceptives, and clomiphene do not touch