Polycystic Ovary Syndrome: Metabolic Burden and Reproductive Consequences

PCOS is a common endocrine disorder in reproductive-age women characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Beyond anovulation and infertility, PCOS carries a substantial metabolic load—notably insulin resistance, obesity, dyslipidemia, and high prevalence of metabolic syndrome—that amplifies adverse fertility and pregnancy outcomes. Insulin resistance is a central driver linking metabolic and reproductive abnormalities by enhancing ovarian/thecal androgen synthesis and impairing folliculogenesis, thereby reducing ovulation and increasing miscarriage risk. Clinically, early metabolic risk stratification and targeted lifestyle and insulin-sensitizing strategies are pivotal to improve both reproductive and long-term cardiometabolic outcomes.