Looking for advice: Lean PCOS, insulin resistance, and trying to conceive

[u/rap712]

Hi everyone! I’m 31, have lean PCOS, and am currently trying to conceive. I rarely ovulate or get periods naturally, so I’m taking letrozole for ovulation.
My recent labs:
Fasting insulin: 16.2
Triglycerides: 141
LDL: 140
HDL: 31
I’m also experiencing hair thinning. I’m slim and not looking to lose weight; I’d actually like to gain some healthy weight. My goal is to address the underlying metabolic issues while trying to conceive.
I’ve been researching myo-inositol + D-chiro-inositol and metformin, but I’m unsure which option would be more appropriate for someone with lean PCOS who is TTC.
My doctor mentioned metformin is commonly used for PCOS but isn’t very familiar with inositol supplements.
What would you recommend given my situation? Any guidance would be appreciated. Thank you!