Current Medicinal Chemistry

Current Medicinal Chemistry

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Review Article

Next-generation Approaches in Targeting Polycystic Ovarian Syndrome: Innovative Strategies

Author(s): Pavithra Lakshmi Narayanan, Subalakshmi Sugumar, Rapuru Rushendran and Chitra Vellapandian*

Volume 33, Issue 1, 2026

Published on: 12 May, 2025

Page: [57 - 75] Pages: 19

DOI: 10.2174/0109298673368951250404170052

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Abstract

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects millions of women worldwide and is characterized by ovarian dysfunction, hyperandrogenism, and metabolic abnormalities. The traditional diagnostic and therapeutic approaches often fail to address the multifaceted nature of PCOS. Recent advancements in next-generation sequencing (NGS), bioinformatics, and precision medicine have paved the way for innovative research and therapeutic strategies that promise to revolutionize PCOS management. This review focuses on exploring the genetic and molecular mechanisms of PCOS using innovative methodologies, such as genome-wide association studies (GWAS), transcriptomics, and computational approaches. Integrating big data analytics and machine learning algorithms enhances the predictive accuracy of PCOS diagnoses and treatment outcomes. In addition, the emergence of personalized medicine has enabled tailored therapeutic interventions based on individual genetic profiles and phenotypic expression. Furthermore, we explored the development of novel pharmacological agents and combinational therapies to enhance the understanding of PCOS pathophysiology. These approaches also focus on reducing inflammation, improving insulin sensitivity, and optimizing hormonal balance to achieve optimal health outcomes. The potential of digital health tools, including mobile applications and wearable technologies, to support self-monitoring and patient engagement in PCOS management is also highlighted. In conclusion, the integration of next-generation technologies and innovative research is necessary to transform the field of PCOS diagnosis and treatment, offering hope for more effective and individualized care. These underscore the importance of continued investment in advanced research methodologies and the adoption of personalized therapeutic strategies to address the complexities of PCOS.

Keywords: Bioinformatics, innovative research, machine learning, polycystic ovarian syndrome, therapeutic strategies, molecular docking.

[1]
Azziz, R.; Carmina, E.; Chen, Z.; Dunaif, A.; Laven, J.S.E.; Legro, R.S.; Lizneva, D.; Natterson-Horowtiz, B.; Teede, H.J.; Yildiz, B.O. Polycystic ovary syndrome. Nat. Rev. Dis. Primers, 2016, 2(1), 16057.
[http://dx.doi.org/10.1038/nrdp.2016.57] [PMID: 27510637]
[2]
Sarawad, S.S. Polycystic ovary syndrome (PCOS): A comprehensive review. Int. J. Adv. Nurs. Manag., 2023, 11(4), 264-265.
[http://dx.doi.org/10.52711/2454-2652.2023.00059]
[3]
Hoeger, K.M.; Dokras, A.; Piltonen, T. Update on PCOS: Consequences, challenges, and guiding treatment. J. Clin. Endocrinol. Metab., 2021, 106(3), e1071-e1083.
[http://dx.doi.org/10.1210/clinem/dgaa839] [PMID: 33211867]
[4]
Bharathi, R.V.; Swetha, S.; Neerajaa, J.; Madhavica, J.V.; Janani, D.M.; Rekha, S.N.; Sanya, R.; Usha, B. An epidemiological survey: Effect of predisposing factors for PCOS in Indian urban and rural population. Middle East Fertil. Soc. J., 2017, 22(4), 313-316.
[http://dx.doi.org/10.1016/j.mefs.2017.05.007]
[5]
Dobbie, L.J.; Pittam, B.; Zhao, S.S.; Alam, U.; Hydes, T.J.; Barber, T.M.; Cuthbertson, D.J. Childhood, adolescent, and adulthood adiposity are associated with risk of PCOS: A Mendelian randomization study with meta-analysis. Hum. Reprod., 2023, 38(6), 1168-1182.
[http://dx.doi.org/10.1093/humrep/dead053] [PMID: 37015099]
[6]
Bharali, M.D.; Rajendran, R.; Goswami, J.; Singal, K.; Rajendran, V. Prevalence of polycystic ovarian syndrome in india: A systematic review and meta-analysis. Cureus, 2022, 14(12), e32351.
[http://dx.doi.org/10.7759/cureus.32351] [PMID: 36628015]
[7]
Ding, T.; Hardiman, P.J.; Petersen, I.; Wang, F.F.; Qu, F.; Baio, G. The prevalence of polycystic ovary syndrome in reproductive-aged women of different ethnicity: A systematic review and meta-analysis. Oncotarget, 2017, 8(56), 96351-96358.
[http://dx.doi.org/10.18632/oncotarget.19180] [PMID: 29221211]
[8]
Kirby, J. Polycystic ovary syndrome. In: Acneiform Eruptions in Dermatology; Zeichner, J., Ed.; Springer, New York, NY, 2013; pp. 149-154.
[http://dx.doi.org/10.1007/978-1-4614-8344-1_21]
[9]
Johra, T.H.; Akther, N.; Rabeya, S.; Khan, M.A.H.K.; Amanullah, M. Observing the use of insulin sensitizers for ovulation induction among PCOS women. Schol. J. Appl. Med. Sci., 2023, 11(1), 236-241.
[http://dx.doi.org/10.36347/sjams.2023.v11i01.036]
[10]
Dason, E.S.; Koshkina, O.; Chan, C.; Sobel, M. Diagnosis and management of polycystic ovarian syndrome. CMAJ, 2024, 196(3), E85-E94.
[http://dx.doi.org/10.1503/cmaj.231251] [PMID: 38286488]
[11]
Inan, C.; Karadağ, C. Correlation between ovarian morphology and biochemical and hormonal parameters in polycystic ovary syndrome. Pak. J. Med. Sci., 2016, 32(3), 742-745.
[http://dx.doi.org/10.12669/pjms.323.10082] [PMID: 27375725]
[12]
Revathi, R.; Julius, A. A biological effect of sex hormone binding globulin and testosterone in polycystic ovary syndrome (PCOS) Obese Women. Res. J. Pharm. Tech., 2017, 10(7), 2143-2145.
[http://dx.doi.org/10.5958/0974-360X.2017.00377.8]
[13]
Ajmal, N.; Khan, S.Z.; Shaikh, R. Polycystic ovary syndrome (PCOS) and genetic predisposition: A review article. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 2019, 3, 100060.
[http://dx.doi.org/10.1016/j.eurox.2019.100060] [PMID: 31403134]
[14]
Mukherjee, P.; Sanyal, S.; Chadha, S.; Mukherjee, S. The impact of polycystic ovary syndrome (PCOS) on the risk of developing ovarian cancer and thyroid disorders: A comprehensive review. Endocr. Metab. Disord., 2024, 24(5), 562-572.
[15]
Deswal, R.; Nanda, S.; Dang, A.S. Association of Luteinizing hormone and LH receptor gene polymorphism with susceptibility of polycystic ovary syndrome. Syst. Biol. Reprod. Med., 2019, 65(5), 400-408.
[http://dx.doi.org/10.1080/19396368.2019.1595217] [PMID: 30958034]
[16]
Witchel, S.F.; Plant, T.M. Intertwined reproductive endocrinology: Puberty and polycystic ovary syndrome. Curr. Opin. Endocr. Metab. Res., 2020, 14, 127-136.
[http://dx.doi.org/10.1016/j.coemr.2020.07.004] [PMID: 33102929]
[17]
Lobo, R.A.; Carmina, E. The importance of diagnosing the polycystic ovary syndrome. Ann. Intern. Med., 2000, 132(12), 989-993.
[http://dx.doi.org/10.7326/0003-4819-132-12-200006200-00010] [PMID: 10858183]
[18]
Seow, K.M.; Chang, Y.W.; Chen, K.H.; Juan, C.C.; Huang, C.Y.; Lin, L.T.; Tsui, K.H.; Chen, Y.J.; Lee, W.L.; Wang, P.H. Molecular mechanisms of laparoscopic ovarian drilling and its therapeutic effects in polycystic ovary syndrome. Int. J. Mol. Sci., 2020, 21(21), 8147.
[http://dx.doi.org/10.3390/ijms21218147] [PMID: 33142702]
[19]
Arentz, S.; Smith, C.A.; Abbott, J.; Fahey, P.; Cheema, B.S.; Bensoussan, A. Combined lifestyle and herbal medicine in overweight women with polycystic ovary syndrome (PCOS): A randomized controlled trial. Phytother. Res., 2017, 31(9), 1330-1340.
[http://dx.doi.org/10.1002/ptr.5858] [PMID: 28685911]
[20]
Joshi, M.; Shankar, R.; Pathak, K.; Yadav, R. Polycystic ovarian syndrome: A review covering phytoconstituents for its outstrip management. Pharmacolog. Res. - Mod. Chin. Med., 2021, 1, 100011.
[http://dx.doi.org/10.1016/j.prmcm.2021.100011]
[21]
Sahin, T.K.; Ayasun, R.; Rizzo, A.; Guven, D.C. Prognostic value of neutrophil-to-eosinophil ratio (NER) in cancer: A systematic review and meta-analysis. Cancers (Basel), 2024, 16(21), 3689.
[http://dx.doi.org/10.3390/cancers16213689] [PMID: 39518127]
[22]
Guven, D.C.; Erul, E.; Kaygusuz, Y.; Akagunduz, B.; Kilickap, S.; De Luca, R.; Rizzo, A. Immune checkpoint inhibitor-related hearing loss: A systematic review and analysis of individual patient data. Support. Care Cancer, 2023, 31(11), 624.
[http://dx.doi.org/10.1007/s00520-023-08083-w] [PMID: 37819422]
[23]
Yao, X.; Wang, X. Bioinformatics searching of diagnostic markers and immune infiltration in polycystic ovary syndrome. Front. Genet., 2022, 13, 937309.
[http://dx.doi.org/10.3389/fgene.2022.937309] [PMID: 36118901]
[24]
Barrera, F.J.; Brown, E.D.L.; Rojo, A.; Obeso, J.; Plata, H.; Lincango, E.P.; Terry, N.; Rodríguez-Gutiérrez, R.; Hall, J.E.; Shekhar, S. Application of machine learning and artificial intelligence in the diagnosis and classification of polycystic ovarian syndrome: A systematic review. Front. Endocrinol. (Lausanne), 2023, 14, 1106625.
[http://dx.doi.org/10.3389/fendo.2023.1106625] [PMID: 37790605]
[25]
Moral, P.; Mustafi, D.; Sahana, S.K. PODBoost: An explainable AI model for polycystic ovarian syndrome detection using grey wolf-based feature selection approach. Neural Comput. Appl., 2024, 36(30), 18627-18644.
[http://dx.doi.org/10.1007/s00521-024-10171-9]
[26]
Khanna, V.V.; Chadaga, K.; Sampathila, N.; Prabhu, S.; Bhandage, V.; Hegde, G.K. A distinctive explainable machine learning framework for detection of polycystic ovary syndrome. Appl. Sys. Innova., 2023, 6(2), 32.
[http://dx.doi.org/10.3390/asi6020032]
[27]
Adla, Y.A.A.; Raydan, D.G.; Charaf, M-Z.J.; Saad, R.A.; Nasreddine, J.; Diab, M.O. Automated Detection of Polycystic Ovary Syndrome Using Machine Learning Techniques. 2021 Sixth International Conference on Advances in Biomedical Engineering, Alaska, 2021, pp. 208–212.
[http://dx.doi.org/10.1109/ICABME53305.2021.9604905]
[28]
Subha, R.; Nayana, B.R.; Radhakrishnan, R.; Sumalatha, P. Computerized diagnosis of polycystic ovary syndrome using machine learning and swarm intelligence techniques. Res. Squa., 2023, 2, 27767.
[http://dx.doi.org/10.21203/rs.3.rs-2027767/v2]
[29]
Tsaliki, K.C. AI-driven hormonal profiling: A game-changer in polycystic ovary syndrome prevention. J. Res. Appl. Sci. Enginee. Tech., 2024, 12, 364-371.
[http://dx.doi.org/10.22214/ijraset.2024.61001]
[30]
Prabhu, B.N.; Kanchamreddy, S.H.; Sharma, A.R.; Bhat, S.K.; Bhat, P.V.; Kabekkodu, S.P.; Satyamoorthy, K.; Rai, P.S. Conceptualization of functional single nucleotide polymorphisms of polycystic ovarian syndrome genes: An in silico approach. J. Endocrinol. Invest., 2021, 44(8), 1783-1793.
[http://dx.doi.org/10.1007/s40618-021-01498-4] [PMID: 33506367]
[31]
Sarkar, C.; Maitra, A. Deciphering the cis-regulatory elements of co-expressed genes in PCOS by in silico analysis. Gene, 2008, 408(1-2), 72-84.
[http://dx.doi.org/10.1016/j.gene.2007.10.026] [PMID: 18055135]
[32]
Muccee, F.; Bijou, O.; Harakeh, S.; Adawiyah, R.; Sayyed, R.Z.; Haghshenas, L.; Alshehri, D.; Ansari, M.J.; Ghazanfar, S. In-silico investigation of effects of single-nucleotide polymorphisms in pcos-associated cyp11a1 gene on mutated proteins. Genes (Basel), 2022, 13(7), 1231.
[http://dx.doi.org/10.3390/genes13071231] [PMID: 35886014]
[33]
Dhar, S.; Bhattacharjee, P. Clinical-exome sequencing unveils the genetic landscape of polycystic ovarian syndrome (PCOS) focusing on lean and obese phenotypes: Implications for cost-effective diagnosis and personalized treatment. Sci. Rep., 2024, 14(1), 24468.
[http://dx.doi.org/10.1038/s41598-024-75719-0] [PMID: 39424910]
[34]
Patil, K.; Joseph, S.; Shah, J.; Mukherjee, S. An integrated in silico analysis highlighted angiogenesis regulating miRNA-mRNA network in PCOS pathophysiology. J. Assist. Reprod. Genet., 2022, 39(2), 427-440.
[http://dx.doi.org/10.1007/s10815-022-02396-1] [PMID: 35032287]
[35]
Butler, A.E.; Ramachandran, V.; Hayat, S.; Dargham, S.R.; Cunningham, T.K.; Benurwar, M.; Sathyapalan, T.; Najafi-Shoushtari, S.H.; Atkin, S.L. Expression of microRNA in follicular fluid in women with and without PCOS. Sci. Rep., 2019, 9(1), 16306.
[http://dx.doi.org/10.1038/s41598-019-52856-5] [PMID: 31705013]
[36]
Tiwari, A.; Modi, S.J.; Girme, A.; Hingorani, L. Network pharmacology-based strategic prediction and target identification of apocarotenoids and carotenoids from standardized Kashmir saffron (Crocus sativus L.) extract against polycystic ovary syndrome. Medicine (Baltimore), 2023, 102(32), e34514.
[http://dx.doi.org/10.1097/MD.0000000000034514] [PMID: 37565925]
[37]
Begum, R.F.; Mohan, S. Systematic exploration of network pharmacology, in silico modeling and pharmacokinetic profiling for vitamin E in polycystic ovarian syndrome. Futur. Sci. OA, 2024, 10(1), FS0952.
[38]
Rushendran, R.; Chitra, V. Antimigraine activity of Asarinin by OPRM1 pathway with multifaceted impacts through network analysis. Sci. Rep., 2024, 14(1), 20207.
[http://dx.doi.org/10.1038/s41598-024-70933-2] [PMID: 39215033]
[39]
Femi-Olabisi, J.F.; Ishola, A.A.; Olujimi, F.O. Effect of Parquetina nigrescens (Afzel.) Leaves on Letrozole-Induced PCOS in Rats: A Molecular Insight into its phytoconstituents. Appl. Biochem. Biotechnol., 2023, 195(8), 4744-4774.
[http://dx.doi.org/10.1007/s12010-023-04537-3] [PMID: 37171758]
[40]
Joshi, S.; Srivastava, R. Tracing the pathways and mechanisms involved in medicinal uses of flaxseed with computational methods and bioinformatics tools. Front Chem., 2024, 11, 1276052.
[http://dx.doi.org/10.3389/fchem.2023.1276052] [PMID: 38283897]
[41]
Moka, M.K. Computational investigation of four isoquinoline alkaloids against polycystic ovarian syndrome. J. Biomol. Struct. Dyn., 2023, 42(2), 1-13.
[PMID: 37315995]
[42]
Pavithra, L.; Ilango, K. Identification of phytoconstituents for combating polycystic ovarian syndrome through in silico techniques. Indian J. Biochem. Biophys., 2023, 60(2), 99-107.
[43]
Begum, R.F.; Mohan, S. Insights into vitamin E with combined oral contraceptive on insr gene in pcos by integrating in silico and in vivo approaches. Appl. Biochem. Biotechnol., 2024, 196(6), 2990-3009.
[http://dx.doi.org/10.1007/s12010-023-04710-8] [PMID: 37610513]
[44]
Zou, J.; Li, Y.; Liao, N.; Liu, J.; Zhang, Q.; Luo, M.; Xiao, J.; Chen, Y.; Wang, M.; Chen, K.; Zeng, J.; Mo, Z. Identification of key genes associated with polycystic ovary syndrome (PCOS) and ovarian cancer using an integrated bioinformatics analysis. J. Ovarian Res., 2022, 15(1), 30.
[http://dx.doi.org/10.1186/s13048-022-00962-w] [PMID: 35227296]
[45]
Zou, L.; Feng, Q.; Xia, W.; Zhu, C. Bioinformatics analysis of the common targets of miR-223-3p, miR-122-5p, and miR-93-5p in polycystic ovarian syndrome. Front. Genet., 2023, 14, 1097706.
[http://dx.doi.org/10.3389/fgene.2023.1097706] [PMID: 36873932]
[46]
Liu, Q.; Zhu, Z.; Kraft, P.; Deng, Q.; Stener-Victorin, E.; Jiang, X. Genomic correlation, shared loci, and causal relationship between obesity and polycystic ovary syndrome: A large-scale genome-wide cross-trait analysis. BMC Med., 2022, 20(1), 66.
[http://dx.doi.org/10.1186/s12916-022-02238-y] [PMID: 35144605]
[47]
Alur, V.; Vastrad, B.; Raju, V.; Vastrad, C.; Kotturshetti, S. The identification of key genes and pathways in polycystic ovary syndrome by bioinformatics analysis of next-generation sequencing data. Middle East Fertil. Soc. J., 2024, 29(1), 53.
[http://dx.doi.org/10.1186/s43043-024-00212-7]
[48]
Laven, J.S.E. Follicle stimulating hormone receptor (FSHR) polymorphisms and polycystic ovary syndrome (PCOS). Front. Endocrinol. (Lausanne), 2019, 10, 23.
[http://dx.doi.org/10.3389/fendo.2019.00023] [PMID: 30809190]
[49]
Homburg, R. Androgen circle of polycystic ovary syndrome. Hum. Reprod., 2009, 24(7), 1548-1555.
[http://dx.doi.org/10.1093/humrep/dep049] [PMID: 19279033]
[50]
Abbott, D.H.; Barnett, D.K.; Bruns, C.M.; Dumesic, D.A. Androgen excess fetal programming of female reproduction: A developmental aetiology for polycystic ovary syndrome? Hum. Reprod. Update, 2005, 11(4), 357-374.
[http://dx.doi.org/10.1093/humupd/dmi013] [PMID: 15941725]
[51]
Maqbool, M.; Dar, M.A.; Gani, I.; Geer, M.I. Insulin resistance and polycystic ovary syndrome: A review. J. Drug Deliv. Ther., 2019, 9(1-s), 433-436.
[http://dx.doi.org/10.22270/jddt.v9i1-s.2275]
[52]
Giallauria, F.; Palomba, S.; Vigorito, C.; Tafuri, M.G.; Colao, A.; Lombardi, G.; Orio, F. Androgens in polycystic ovary syndrome: The role of exercise and diet. Semin. Reprod. Med., 2009, 27, 306-315.
[53]
Larson, M.H.; Gilbert, L.A.; Wang, X.; Lim, W.A.; Weissman, J.S.; Qi, L.S. CRISPR interference (CRISPRi) for sequence-specific control of gene expression. Nat. Protoc., 2013, 8(11), 2180-2196.
[http://dx.doi.org/10.1038/nprot.2013.132] [PMID: 24136345]
[54]
Kazi, T.A.; Biswas, S.R. CRISPR/dCas system as the modulator of gene expression. Prog. Mol. Biol. Transl. Sci., 2021, 178, 99-122.
[http://dx.doi.org/10.1016/bs.pmbts.2020.12.002] [PMID: 33685602]
[55]
Merviel, P.; James, P.; Bouée, S.; Le Guillou, M.; Rince, C.; Nachtergaele, C.; Kerlan, V. Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod. Health, 2021, 18(1), 13.
[http://dx.doi.org/10.1186/s12978-021-01073-3] [PMID: 33468143]
[56]
Yifu, P. A review of antioxidant N-acetylcysteine in addressing polycystic ovary syndrome. Gynecol. Endocrinol., 2024, 40(1), 2381498.
[http://dx.doi.org/10.1080/09513590.2024.2381498] [PMID: 39039898]
[57]
Maarouf, T.; Mohamed, D.; Tantawy, A.; Eid, P.M. Effect of omega-3 fatty acids on hormonal profile and ovarian stromal blood flow in patients with polycystic ovary syndrome. Evid. Bas. Women’s Heal. J., 2019, 9(4), 542-548.
[http://dx.doi.org/10.21608/ebwhj.2019.64357]
[58]
Scannell, N.; Mantzioris, E.; Rao, V.; Pandey, C.; Ee, C; Mousa, A; Moran, L; Villani, A. Use of nutraceuticals and micronutrient supplementation for the management of polycystic ovary syndrome: A scoping review. Nutrit. Soci., 2024, 83, E176.
[http://dx.doi.org/10.1017/S0029665124001940]
[59]
Zhang, N.; Liao, Y.; Zhao, H.; Chen, T.; Jia, F.; Yu, Y.; Zhu, S.; Wang, C.; Zhang, W.; Liu, X. Polycystic ovary syndrome and 25-hydroxyvitamin D: A bidirectional two-sample Mendelian randomization study. Front. Endocrinol. (Lausanne), 2023, 14, 1110341.
[http://dx.doi.org/10.3389/fendo.2023.1110341] [PMID: 36967791]
[60]
Yurtdaş, G.; Akdevelioğlu, Y. A new approach to polycystic ovary syndrome: The gut microbiota. J. Am. Coll. Nutr., 2020, 39(4), 371-382.
[http://dx.doi.org/10.1080/07315724.2019.1657515] [PMID: 31513473]
[61]
Salehi, S.; Allahverdy, J.; Pourjafar, H.; Sarabandi, K.; Jafari, S.M. Gut microbiota and polycystic ovary syndrome (PCOS): Understanding the pathogenesis and the role of probiotics as a therapeutic strategy. Probio. Antimicrob. Prot., 2024, 16(5), 1553-1565.
[http://dx.doi.org/10.1007/s12602-024-10223-5] [PMID: 38421576]
[62]
Li, Y.; Tan, Y.; Xia, G.; Shuai, J. Effects of probiotics, prebiotics, and synbiotics on polycystic ovary syndrome: A systematic review and meta-analysis. Crit. Rev. Food Sci. Nutr., 2023, 63(4), 522-538.
[http://dx.doi.org/10.1080/10408398.2021.1951155] [PMID: 34287081]
[63]
Wesołowska, Z.; Zdun, S.; Walczak, K.; Gaweł, W.; Jędruszczak, P. The impact of using probiotics on metabolic disorders of women with polycystic ovary syndrome. Qual. Spor., 2023, 9(2), 18-22.
[http://dx.doi.org/10.12775/QS.2023.09.02.002]
[64]
Rizzo, A.; Santoni, M.; Mollica, V.; Fiorentino, M.; Brandi, G.; Massari, F. Microbiota and prostate cancer. Semin Canc. Biol., 2022, 86(Pt 3), 1058-1065.
[http://dx.doi.org/10.1016/j.semcancer.2021.09.007]
[65]
Ravat, F.K.; Goswami, J.R.; Nair, S.M.; Thummar, K.N. A review of metabolic and microbial influences on women with polycystic ovarian syndrome. Steroids, 2024, 212, 109512.
[http://dx.doi.org/10.1016/j.steroids.2024.109512] [PMID: 39278517]
[66]
Zeng, B.; Lai, Z.; Sun, L.; Zhang, Z.; Yang, J.; Li, Z.; Lin, J.; Zhang, Z. Structural and functional profiles of the gut microbial community in polycystic ovary syndrome with insulin resistance (IR-PCOS): A pilot study. Res. Microbiol., 2019, 170(1), 43-52.
[http://dx.doi.org/10.1016/j.resmic.2018.09.002] [PMID: 30292647]
[67]
Somunkiran, A.; Yavuz, T.; Yucel, O.; Ozdemir, I. Anti-Müllerian hormone levels during hormonal contraception in women with polycystic ovary syndrome. Eur. J. Obstet. Gynecol. Reprod. Biol., 2007, 134(2), 196-201.
[http://dx.doi.org/10.1016/j.ejogrb.2007.01.012] [PMID: 17335955]
[68]
Sova, H.; Unkila-Kallio, L.; Tiitinen, A.; Hippeläinen, M.; Perheentupa, A.; Tinkanen, H.; Puukka, K.; Bloigu, R.; Piltonen, T.; Tapanainen, J.S.; Morin-Papunen, L. Hormone profiling, including anti-Müllerian hormone (AMH), for the diagnosis of polycystic ovary syndrome (PCOS) and characterization of PCOS phenotypes. Gynecol. Endocrinol., 2019, 35(7), 595-600.
[http://dx.doi.org/10.1080/09513590.2018.1559807] [PMID: 30668196]
[69]
Vosnakis, C.; Georgopoulos, N.A.; Rousso, D.; Mavromatidis, G.; Katsikis, I.; Roupas, N.D.; Mamali, I.; Panidis, D. Diet, physical exercise and orlistat administration increase serum anti-müllerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS). Gynecol. Endocrinol., 2013, 29(3), 242-245.
[http://dx.doi.org/10.3109/09513590.2012.736557] [PMID: 23194076]
[70]
Singh, R.; Kaur, S.; Yadav, S.; Bhatia, S. Gonadotropins as pharmacological agents in assisted reproductive technology and polycystic ovary syndrome. Trends Endocrinol. Metab., 2023, 34(4), 194-215.
[http://dx.doi.org/10.1016/j.tem.2023.02.002] [PMID: 36863888]
[71]
Palomba, S.; Daolio, J.; La Sala, G.B. Oocyte competence in women with polycystic ovary syndrome. Trends Endocrinol. Metab., 2017, 28(3), 186-198.
[http://dx.doi.org/10.1016/j.tem.2016.11.008] [PMID: 27988256]
[72]
Walters, K.A. Polycystic ovary syndrome: Is it androgen or estrogen receptor? Curr. Opin. Endocr. Metab. Res., 2020, 12, 1-7.
[http://dx.doi.org/10.1016/j.coemr.2020.01.003]
[73]
Wang, K.; Li, Y.; Chen, Y. Androgen excess: A hallmark of polycystic ovary syndrome. Front. Endocrinol. (Lausanne), 2023, 14, 1273542.
[http://dx.doi.org/10.3389/fendo.2023.1273542] [PMID: 38152131]
[74]
Ojeda-Ojeda, M.; Murri, M.; Insenser, M.; Escobar-Morreale, H. Mediators of low-grade chronic inflammation in polycystic ovary syndrome (PCOS). Curr. Pharm. Des., 2013, 19(32), 5775-5791.
[http://dx.doi.org/10.2174/1381612811319320012] [PMID: 23448487]
[75]
Velez, L.M.; Seldin, M.; Motta, A.B. Inflammation and reproductive function in women with polycystic ovary syndrome. Biol. Reprod., 2021, 104(6), 1205-1217.
[http://dx.doi.org/10.1093/biolre/ioab050] [PMID: 33739372]
[76]
Ye, Z.; Zhao, J.; Li, R. Effects of immune cells and cytokines on the endometrial immune microenvironment in polycystic ovary syndrome. Gynecol. Obstet. Clini. Med., 2022, 2(4), 181-185.
[http://dx.doi.org/10.1016/j.gocm.2022.10.001]
[77]
Rizzo, A.; Santoni, M.; Mollica, V.; Logullo, F.; Rosellini, M.; Marchetti, A.; Faloppi, L.; Battelli, N.; Massari, F. Peripheral neuropathy and headache in cancer patients treated with immunotherapy and immuno-oncology combinations: The MOUSEION-02 study. Expert Opin. Drug Metab. Toxicol., 2021, 17(12), 1455-1466.
[http://dx.doi.org/10.1080/17425255.2021.2029405] [PMID: 35029519]
[78]
Di Federico, A.; Mosca, M.; Pagani, R.; Carloni, R.; Frega, G.; De Giglio, A.; Rizzo, A.; Ricci, D.; Tavolari, S.; Di Marco, M.; Palloni, A.; Brandi, G. Immunotherapy in pancreatic cancer: Why do we keep failing? a focus on tumor immune microenvironment, predictive biomarkers and treatment outcomes. Cancers (Basel), 2022, 14(10), 2429.
[http://dx.doi.org/10.3390/cancers14102429] [PMID: 35626033]
[79]
Arjmand, B.; Alaei, S.; Heravani, NF.; Alavi-Moghadam, S.; Payab, M.; Ebrahimpour, M.; Aghayan, H.R.; Goodarzi, P.; Larijani, B. Regenerative medicine perspectives in polycystic ovary syndrome. Adv. Exp. Med. Biol., 2021, 1341, 125-141.
[http://dx.doi.org/10.1007/5584_2021_623] [PMID: 33748932]
[80]
Karam, M.; Najjar, H.; El Sabban, M.; Hamade, A.; Najjar, F. Regenerative medicine for polycystic ovary syndrome: Stem cell-based therapies and brown adipose tissue activation. Stem Cell Rev. Rep., 2023, 19(4), 853-865.
[http://dx.doi.org/10.1007/s12015-023-10505-5] [PMID: 36633783]
[81]
Yang, S.; Ding, S.; Jiang, X.; Sun, B.; Xu, Q. Establishment and adipocyte differentiation of polycystic ovary syndrome-derived induced pluripotent stem cells. Cell Prolif., 2016, 49(3), 352-361.
[http://dx.doi.org/10.1111/cpr.12258] [PMID: 27108524]
[82]
Young, H.E. Fresh isolate adult telomerase positive stem cells: An addition to embryonic stem cells (ESCs), induced pluripotent stem cells (iPSCs), and/or mesenchymal stem cells (MSCs) for regenerative medicine. GSC Adv. Res. Revi., 2023, 16(1), 066-081.
[http://dx.doi.org/10.30574/gscarr.2023.16.1.0301]
[83]
Sun, Y.; Gao, S.; Ye, C.; Zhao, W. Gut microbiota dysbiosis in polycystic ovary syndrome: Mechanisms of progression and clinical applications. Front. Cell. Infect. Microbiol., 2023, 13, 1142041.
[http://dx.doi.org/10.3389/fcimb.2023.1142041] [PMID: 36909735]