Objective: To evaluate the metabolic and endocine effect of dydrogestrel therapy with or without metformin in women with PCOD. Materials and Methods: In this prospective study of women with PCOD, 80 women received metformin 1000 mg , however, 80 cases received metformin 1000 mg plus dydrogestrel 10 mg daily. Body mass index, hormonal and lipid profiles , homocysteine blood level, and insulin resistancy were recorded at baseline, 3, and 6 months. Results: Total cholestrol levels decreased in metformin plus dydrogestrel group (p=0.002) compared with not significant change in metformin in group.In contrast with metformin plus dydrogestrel, significant increased level in homocysteine was seen in mwtformin group(p=0.002). Conclusion: There were no adverse effects of cyclic dydrogestrel plus metformin therapy on metabolic parameters in women with PCOD over a 6-months treatment period.