First line treatment for PCOS is weight loss and metformin if you are significantly overweight. Even a 5-10% weight loss can restore fertility. Plus, metformin sometimes takes a few months before it starts helping. The reason that clomid or other stims could be dangerous for some women with PCOS is because we typically have a ton of follicles sitting around and several of them could respond at the same time and cause hyperstimulation.
That being said, it would be very rare to have that problem with clomid, although you may be at an increased risk of having twins or triplets. My RE was very slow to increase any of my medications while I was TTC with PCOS. I ended up being very resistant to medications and didn't respond to clomid or femara. After starting injectables, I still wasnt having much luck. Then, I had a huge response to the same doses of medications that I had been taking in the past and ended up pregnant with triplets. Unfortunately, I lost them to incompetent cervix. Because of this unpredictable response and the risks of a high order multiple pregnancy, some REs are very cautious with PCOS.
Me: 27 DH: 29
My blog: http://ttcwithpcosrpl.blogspot.com
PCOS, adenomyosis, RPL, & IC
7/09-1/10: Multiple cycles of Clomid and Femara (O'd once)
2/21/10: femara, follistim & repronex... BFP after cycle cancelled for "no response"
6/18/10: femara, repronex, ovidrel
RPL testing: elevated anticardiolipin IgM
8/23/10: acupuncture, femara, repronex, ovidrel
1/7/11: Triplet angels 19w4d due to IC Cadyn
3/30/11: TTC again! Follistim 100iu BFN
4/26/11: Follistim & Ovidrel
#5 Shirodkar cerclage & 17p
Our miracle baby Mason arrived safely 2/22/12