Hi, Absence of a dominant follicle indicates failed induction to complete maturation. This can happen if the dosage is insufficient or if insulin resistance is an associated factor which can easily be corrected through Metformin; hyper-prolactinemia if present should be corrected. Proper monitoring and follow up should be done while under treatment and standard protocol followed before planning induction. This includes complete hormonal profile, glucose tolerance test, tubal patency check and male factor assessment apart form a complete physical evaluation and trans-vaginal sonogram. Hope this helps.