Gynecological Endocrinology最新文献

{"title":"Can menopausal hormone therapy be considered in postmenopausal women who are older than 60 years?","authors":"Panagiotis Anagnostis, Julia K Bosdou, Thomas Georgiou, Dimitrios G Goulis","doi":"10.1080/09513590.2025.2468957","DOIUrl":"https://doi.org/10.1080/09513590.2025.2468957","url":null,"abstract":"","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2468957"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on the mechanism of action of berberine combined with Jianpi Yishen Huazhuo formulation in treating obese polycystic ovary syndrome by activating PI3K/AKT signaling pathway.","authors":"Xiaojing Zhang, Dejiang Ji, Yan Zhang, Cuizhong Du, Lijun Liang, Aqsa Ahmad, Yahong Feng, Gaxi Ye","doi":"10.1080/09513590.2025.2462068","DOIUrl":"10.1080/09513590.2025.2462068","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the effects and potential mechanisms of berberine in conjunction with Jianpi Yishen Huazhuo formulation (JPYSHZF) on obese rats that serve as a model for polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>Letrozole combined with high-fat diet (HFD) was used to establish an overweight PCOS rat model. After successful modeling, each intervention group was monitored for 28 d. An oral glucose tolerance test (OGTT) is performed to assess glucose metabolism. Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of sex hormones and serum levels of gastrointestinal hormones in rats. Biochemical analyzers were used to assess blood lipid levels. The protein expression levels of p38, PI3K, GLUT4, and AKT in ovarian tissue were demonstrated using Western Blotting (WB). Real-time fluorescence quantitative PCR (RT-qPCR) was used to measure the mRNA expression levels of p38, PI3K, GLUT4 and AKT in the same tissue. The morphological changes of ovarian tissue were observed using Hematoxylin-eosin (HE).</p><p><strong>Results: </strong>Treatment with berberine in conjunction with JPYSHZF has been shown to reduce serum testosterone T and luteinizing hormone (LH) levels while increasing serum follicle-stimulating hormone (FSH) and E2 levels. This combination therapy also decreases the LH/FSH ratio and ameliorates polycystic ovary-like pathological changes in the ovaries of rats with PCOS. Additionally, this treatment decreases serum TC, TG, and LDL-c levels while increasing HDL-c levels. It also reduces levels of GLU and Ghrelin while enhancing levels of CCK, PYY, and GLP-1. Furthermore, the relative 6 of PI3K and AKT proteins, as well as the mRNA levels of PI3K, GLUT4, and AKT, were found to be increased.</p><p><strong>Conclusions: </strong>Berberine combined with JPYSHZF can improve the sex hormone levels, ovarian function, glucose and lipid metabolism levels, and gastrointestinal hormone levels in obese PCOS rats by activating the PI3K/AKT signaling pathway, thereby playing a role in treating obese PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2462068"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-specific reference ranges and variation of anti-mülerian hormone in healthy Chinese women of reproductive and perimenopausal age: a nationwide population-based prospective multicenter cross-sectional study.","authors":"Linli Hu, Hongyi Yang, Haining Luo, Yuexiang Zhang, Xiaohong Wang, Sanhua Wei, Qiongfang Wu, Ying Jiang, Xiaoyan Liang, Jianhui Chen, Yingpu Sun","doi":"10.1080/09513590.2024.2431230","DOIUrl":"10.1080/09513590.2024.2431230","url":null,"abstract":"<p><strong>Objective: </strong>To determine the variation of serum AMH levels in healthy Chinese women and establish AMH reference ranges accordingly.</p><p><strong>Methods: </strong>This prospective cross-sectional multicenter study was designed to enroll healthy Chinese women of reproductive age (20-39 years) and perimenopausal age (40-49 years) from five reproductive centers in different regions of China. The study began in May 2022 and finished in February 2023. Age-specific 2.5th-97.5th percentiles AMH reference ranges were established. Multivariable linear regressions were undertaken to analyze the association of serum AMH with different demographic and clinical variables, including antral follicle count (AFC).</p><p><strong>Results: </strong>1113 healthy Chinese women were enrolled, including 614 of premenopausal age and others of reproductive age. The AMH (ng/ml) reference ranges for Chinese women of reproductive age were 0.87-9.89 (20-24 years), 0.42-8.24 (25-29 years), 0.34-7.46 (30-34 years), and 0.28-5.66 (35-39 years). For perimenopausal women, their reference ranges were 0.12-4.63 (40-41 years), 0.01-4.12 (42-43 years), 0.01-2.65 (44-45 years), 0.01-1.90 (46-47 years), and 0.01-1.08 (48-49 years). The regression of AMH on AFC adjusted by age is Log10(AMH)=0.2594-0.0235*Age + 0.0632*AFC.</p><p><strong>Conclusions: </strong>This study established the age-specific serum AMH reference ranges for healthy Chinese women of reproductive and premenopausal age, and observed that the consistent decrease of AMH after 20 years accelerated around the beginning of perimenopause (40 years).</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2431230"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulated serum levels of kisspeptin, NKB, GABA in women with polycystic ovary syndrome and their association with hormonal profiles.","authors":"Ran Cheng, Ying Zhu, Liu-Qing Yang, Lu Xiao, Xiao-Hong Fang, Qin Zhang","doi":"10.1080/09513590.2025.2463533","DOIUrl":"10.1080/09513590.2025.2463533","url":null,"abstract":"<p><strong>Introduction: </strong>The clinical study aimed to evaluate the levels of serum kisspeptin, NKB, and GABA in Chinese patients with polycystic ovary syndrome (PCOS) and explore their association with hormonal profiles, as well as the relationship between these levels in PCOS patients and controls.</p><p><strong>Methods: </strong>From December 2022 to December 2023, medical records of 60 individuals diagnosed with PCOS and 32 healthy subjects were obtained. Serum kisspeptin, NKB and GABA levels were quantified using enzyme-linked immunosorbent assay (ELISA) kits. To assess the correlation, either Pearson's or Spearman's analytical method was employed between serum kisspeptin, NKB, and GABA levels and hormonal profiles.</p><p><strong>Results: </strong>The results showed that serum kisspeptin and NKB levels were significantly lower in PCOS patients (<i>p</i>﹤.05), while GABA levels were elevated compared to those in the control group (<i>p</i>﹤.05). In PCOS patients, kisspeptin was notably positive-correlated with LH and LH/FSH (<i>p</i>﹤.05), but no significant correlation was found between NKB, GABA, and hormonal profiles. In PCOS, GABA levels had a strong positive correlation with NKB levels (<i>r</i> = 0.613, <i>p</i> = .000), but this was not observed in the control group. In control patients, kisspeptin levels were positively associated with NKB (<i>r</i> = 0.475, <i>p</i> = .011), strongly negatively correlated with GABA levels (<i>r</i> = -0.773, <i>p</i> = .000), but these were not observed in the PCOS group.</p><p><strong>Conclusion: </strong>The study concluded that patients with PCOS have dysregulated levels of serum kisspeptin, NKB, and GABA and that they may have paradoxical effects under physiological and pathological situations.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2463533"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced DNMT1 expression associated with TP53 promoter hypomethylation mediate enhanced granulosa cell senescence during ovarian aging.","authors":"Hui Guo, Shu-Hong Pan, Jian Zhao, De-Xian Kong, Cai-Ping Geng, Sui-Bing Miao","doi":"10.1080/09513590.2025.2471549","DOIUrl":"10.1080/09513590.2025.2471549","url":null,"abstract":"<p><strong>Background: </strong>The effects of granulose cell (GC) senescence on premature ovarian insufficiency/premature ovarian failure have been extensively examined, the association between GC senescence and ovarian aging remains to be clarified.</p><p><strong>Methods: </strong>Human and mouse GCs from young/control and old/advanced maternal age (AMA) groups were collected, and GC senescence was determined. The role of the DNMT1-p53 axis in GC senescence during ovarian aging was examined and validated in a KGN cell senescence model.</p><p><strong>Results: </strong>SA-beta-gal-positive GCs were significantly increased in the AMA group, accompanied by activation of the p53-p21 pathway, which was also found in GCs from aged mice and H₂O₂-induced senescent KGN cells. Pyrosequencing methylation analysis revealed that increased expression of p53 was associated with decreased average methylation levels of CpG sites (-1031, -1019, -1012 and -1008) within the <i>P53</i> promoter CpG island in senescenct GCs and KGN cells. We further found that decreased DNA-methyltransferase 1 (DNMT1) expression was responsible for the reduced methylation levels of the CpG sites.</p><p><strong>Conclusion: </strong>Decreased DNMT1 with hypomethylation of the CpG sites within the <i>P53</i> promoter CpG island in GCs is involved in ovarian aging.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2471549"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of light fasting diet therapy on lipid metabolism and sex hormone levels in patients with polycystic ovary syndrome combined with infertility.","authors":"Xiaomei Jiang, Yongfeng Wang, Hong Tang, Jin Ma, Heyue Li","doi":"10.1080/09513590.2025.2458084","DOIUrl":"10.1080/09513590.2025.2458084","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of light fasting diet therapy, including flaxseed powder supplementation, on lipid metabolism and sex hormone levels in patients with polycystic ovary syndrome (PCOS) combined with infertility.</p><p><strong>Methods: </strong>A total of 104 PCOS patients with combined infertility were divided into the control group (<i>n</i> = 52) and intervention group (<i>n</i> = 52) using a random number table method. Over a two-month study period, the control group received light fasting diet therapy with rice flour as a placebo, while the intervention group received light fasting diet therapy supplemented with flaxseed powder. Differences in general clinical data, anthropometric indicators, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), fasting plasma glucose (FPG), fasting insulin (FINS), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)) were compared between the two groups.</p><p><strong>Results: </strong>After treatment, both groups showed significant reductions in FSH, LH, E2, and P levels compared to baseline (<i>p</i> < .05). In the intervention group, the mean FINS and HOMA-IR levels were significantly lower than those in the control group following 2 months of treatment (<i>p</i> < .05). Furthermore, TC, TG, and LDL-C levels were significantly reduced in the intervention group compared to the control group (<i>p</i> < .05).</p><p><strong>Conclusion: </strong>Light fasting diet therapy, especially with flaxseed powder, improves obesity, lipid, and glucose metabolism disorders in PCOS patients with infertility. However, longitudinal studies are needed to better understand these associations and assess long-term effects before considering this intervention as a standard clinical recommendation for PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2458084"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness, burden and treatment of uterine fibroids: a web-based Italian survey.","authors":"Felice Petraglia, Stefano Angioni, Attilio Di Spiezio Sardo, Michele Vignali","doi":"10.1080/09513590.2025.2477499","DOIUrl":"10.1080/09513590.2025.2477499","url":null,"abstract":"<p><p>Uterine fibroids (UFs) are the most common benign tumors in women of reproductive age and one of the leading causes of hysterectomy in Italy. This survey aimed to report how Italian women perceive and approach UFs, in order to raise healthcare professionals (HCPs)', institutions' and women's awareness of UFs and their treatment options. 1508 Italian women aged 30-50 years completed a web-based survey, answering a structured questionnaire focused on UF prevalence, symptomatology and impact, management and awareness. UF self-reported prevalence was 28.8%. Most UF-diagnosed women had symptom(s) before diagnosis (79.0%), and more than a half of UF-diagnosed participants were symptomatic post-diagnosis (55.8%). The most common symptoms after diagnosis were heavy menstrual bleeding (73.1%), dysmenorrhea (50.4%) and pelvic pain (36.8%). UFs negatively affected the quality of life of most symptomatic women, as well as sexuality and employment. Private gynecologists were the key reference HCPs for consultation and UF diagnosis. The most common UF treatments for symptomatic women were surgery (49.2%), followed by oral contraceptives (39.3%). Surgery was also performed for 22.9% of asymptomatic participants. UF-diagnosed participants were not involved in therapeutic choices in 37.6% of cases. Women's knowledge about UFs was mostly superficial (58.7% of all participants), with gynecologists and family/friends as main information sources. Patient-physician communication was rather unsatisfactory, especially about UF therapeutic options and disease impact on sexuality, fertility and lifestyle. This survey highlights that there is still a need to promote patient's knowledge about UFs and empowerment in treatment decision.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2477499"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with menopausal symptoms in southeast Chinese females aged 40-69 years.","authors":"Fei-Xue Wang, Zhou Luo, Yi-Zhou Huang, Yue Zhang, Lin-Juan Ma, Yue-Hong Ding, Yu-Mei Ning, Jie Jiao, Qian Ying, Pei-Ge Song, Ling Xu, Jian-Hong Zhou","doi":"10.1080/09513590.2025.2512832","DOIUrl":"10.1080/09513590.2025.2512832","url":null,"abstract":"<p><p>This study aimed to investigate the prevalence, severity, and associated factors of menopausal symptoms among middle-aged Chinese women. A multicenter, population-based cross-sectional study was conducted, involving 7,485 women aged 40-69 years from Zhejiang Province, China. Data on demographic characteristics, socioeconomic status, and lifestyle factors were collected using a structured questionnaire. Menopausal symptoms were assessed using the modified Kupperman Menopausal Index (mKMI), and multinomial logistic regression models were employed to identify factors linked to menopausal syndrome. The participants had a mean age of 52.4 (±7.3) years, with 46.1% being nonmenopausal and 53.9% postmenopausal. The most common menopausal symptoms were sexual problems (43.6%), insomnia (33.1%), and fatigue (27.5%). Among nonmenopausal women, insomnia was the most prevalent symptom (26.9%), whereas postmenopausal women most frequently reported sexual problems (61.1%). Both the prevalence and severity of menopausal symptoms significantly increased from nonmenopausal to postmenopausal status (<i>p</i> < 0.001). Significant associations were found between menopausal syndrome and factors such as age, menopausal status, education level, residence, income, passive smoking, physical activity, and occupational toxic exposure (<i>p</i> < 0.05). In conclusion, Sexual problems are the most bothersome menopausal symptom among females in southeast China. Postmenopausal females experience more prevalent and more severe symptoms. Additionally, socioeconomic and lifestyle factors play a significant role in menopausal syndrome.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2512832"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare deleterious missense mutation in the <i>AXIN2</i> gene in Chinese women with polycystic ovary syndrome.","authors":"Ying Zhang, Yu Chen, Fa-Ying Liu, Jing-Wen Fu, Xian-Xian Liu, Jun Tan, Ou-Ping Huang, Yang Zou","doi":"10.1080/09513590.2025.2463545","DOIUrl":"10.1080/09513590.2025.2463545","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is an endocrine disorders and characterized by polycystic ovary morphology and oligomenorrhea, affecting fertility and health condition of female around the world. The causative factors of PCOS are complex, and genetic structure remains a long-standing medical challenge in genetics. Previous genome-wide association study (GWAS) showed that Wing-less-related integration site (Wnt) signaling is the most affected pathway among PCOS-related risk genes, and genetic mutations in the Wnt/β-catenin signaling may lead to abnormal development of PCOS.</p><p><strong>Objective: </strong>To explore the possibility of axis inhibitor-2 (<i>AXIN2</i>) variants in Chinese women with PCOS and assess their pathogenicities.</p><p><strong>Methods: </strong>A total of 365 Chinese women with PCOS and 905 women without PCOS as control were recruited from Jiangxi Provincial Maternal and Child Health Hospital, All of the 11 exons and flanking regions of the <i>AXIN2</i> gene were amplified by polymerase chain reaction (PCR), the potential variants were analyzed by Sanger sequencing. The evolutionary conservation analysis of the identified Axin-2 mutant was analyzed among 15 vertebrates from <i>human</i> to <i>zebrafish</i>. The protein structure change was analyzed between the wild-type and mutation-type. The pathogenicity of <i>AXIN2</i> variant was further analyzed in silico.</p><p><strong>Results: </strong>We totally identified 7 genetic variants of <i>AXIN2</i> in this study, including 4 synonymous and 3 missense. Among them, we find a rare deleterious missense variant [p.R714W (c.2140C > T)]. The allele frequencies of this variant were 0.82% and 0.17% in PCOS cases and matched controls, respectively. And it was ranging from 7.89e-5 to 1.47e-4 in public databases. Fisher's exact test indicated that the allele frequencies in PCOS were <i>p <</i> 0.05 compared to both the controls and the databases. Especially, the mutant amino acid site is highly conserved in vertebrates, while the mutation changed the 714th arginine to tryptophan resulting in significant change in the protein structural of Axin-2.</p><p><strong>Conclusion: </strong>In this study, we identified a rare deleterious missense <i>AXIN2</i> mutation [p.R714W (c.2140C > T)] in Chinese women with PCOS, and this mutant is probably pathogenic. This study may provide a new perspective on revealing the genetic variation of PCOS.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2463545"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of letrozole doses on clinical pregnancy rates in polycystic ovary syndrome: a systematic review and network meta-analysis.","authors":"Yanting Sun, Jun Wang, Guofeng Chen","doi":"10.1080/09513590.2025.2504977","DOIUrl":"10.1080/09513590.2025.2504977","url":null,"abstract":"<p><p>Letrozole, an aromatase inhibitor, is commonly used for ovulation induction in patients with polycystic ovary syndrome (PCOS). However, the effect of different doses of letrozole on pregnancy outcomes remains controversial. This systematic review and network meta‑analysis aims to compare the effects of different doses of letrozole on pregnancy outcomes in PCOS patients. A systematic search was performed in databases such as PubMed, WOS, and Wanfang for randomized clinical trials (RCTs) assessing different doses of letrozole in PCOS patients. The primary outcome was pregnancy outcome. A network meta‑analysis was conducted using Stata 17's network package and the 'netmeta' and 'gemtc' packages in R software. A total of 30 RCTs involving 3663 patients were included, comparing 11 intervention strategies. Compared with 2.5 mg letrozole, 5 mg letrozole (OR = 1.99, 95% CI: 1.47-2.68; <i>p</i> > 0.05), 7.5 mg letrozole (OR = 1.89, 95% CI: 1.17-3.06; <i>p</i> > 0.05), and 7.5 mg letrozole combined with clomiphene (OR = 7.60, 95% CI: 1.33-43.35; <i>p</i> > 0.05) all significantly improved pregnancy outcomes. Additionally, compared with 2.5 mg letrozole combined with human gonadotropin (HMG), 5 mg (OR = 1.12), 7.5 mg (OR = 1.19), and 20 mg (OR = 1.72) letrozole combined with HMG showed improvements in pregnancy rates, though the differences were not statistically significant (<i>p</i> > 0.05). The lack of unpublished studies and non‑English publications may have introduced publication bias. Letrozole treatment significantly improves pregnancy outcomes in PCOS patients. Moderate‑dose letrozole is recommended as the most effective strategy for improving pregnancy outcomes. Further clinical studies are required to confirm these findings.</p>","PeriodicalId":12865,"journal":{"name":"Gynecological Endocrinology","volume":"41 1","pages":"2504977"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}