Journal of Ovarian Research最新文献

{"title":"Beyond metabolic comorbidity: metabolic health stratification reveals BMI-ART associations in tubal factor infertility.","authors":"Xiaoju Wan, Min Yu, Xingwu Wu, Zhihui Huang, Jun Tan","doi":"10.1186/s13048-026-02248-x","DOIUrl":"10.1186/s13048-026-02248-x","url":null,"abstract":"<p><strong>Background: </strong>The association between body mass index (BMI) and assisted reproductive technology (ART) outcomes remains inconsistent, potentially due to confounding by metabolic comorbidities and underlying infertility etiologies. This study introduced metabolic health stratification to reproductive medicine to examine whether the impact of BMI on ART outcomes differs by metabolic status, independent of ovarian reserve impairment or reproductive endocrinopathies.</p><p><strong>Methods: </strong>This retrospective cohort study included 3,770 women with tubal factor infertility and normal ovarian reserve who underwent their first IVF/ICSI cycle between January 2016 and March 2026. The cohort was divided into metabolically healthy (n = 1,849) and metabolically unhealthy (n = 1,921) subgroups based on blood pressure, glucose metabolism, and lipid profiles. Outcomes included oocyte yield (with basal FSH examined as a potential intermediate variable), embryological parameters (MII oocyte rate, 2PN rate, day 3 good-quality embryo rate, good-quality blastocyst formation rate), and clinical outcomes (clinical pregnancy, miscarriage, live birth). Indirect pathway analysis and multivariable logistic regression with power and effect size analyses were performed.</p><p><strong>Results: </strong>BMI was positively associated with oocyte yield, and the indirect pathway through FSH accounted for 4.7-6.3% of this association-findings that were consistent across both metabolic subgroups (all between-cohort P > 0.05). Overweight/obesity was associated with lower 2PN rate in IVF (- 3.4%) and ICSI (- 3.9%), reduced good-quality blastocyst formation rate in IVF (- 3.5%), and lower MII oocyte rate in ICSI (- 4.1%). Underweight was associated with higher day 3 good-quality embryo rate in ICSI (+ 11.4%). For clinical outcomes, no associations remained significant after multiple comparison correction; however, underweight showed a clinically meaningful reduction in miscarriage rate (- 3.5%), while effect sizes for clinical pregnancy and live birth were small (≤ 2.5% absolute difference). No significant BMI-metabolic status interactions were detected for any outcome.</p><p><strong>Conclusions: </strong>The impact of BMI on ART outcomes is independent of metabolic health status. Overweight/obesity exerts consistent detrimental effects on embryological outcomes, while metabolic comorbidities do not modify these associations. Metabolic health stratification suggests that adiposity per se, rather than its associated metabolic abnormalities, may be the primary factor associated with BMI-ART outcomes in tubal factor infertility, although the lack of significant interaction does not exclude metabolic modification.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The oncology and fertility outcomes in patients with ovarian steroid cell tumors: a single center experience.","authors":"Jiayuan Zhao, Dan Wang, Yuan Li, Congwei Jia, Yinbo Xiao, Mi Zou, Peng Peng, Junjun Yang, Yang Xiang","doi":"10.1186/s13048-026-02214-7","DOIUrl":"10.1186/s13048-026-02214-7","url":null,"abstract":"<p><strong>Objective: </strong>Ovarian steroid cell tumor (SCT) is a rare ovarian neoplasm with uncertain malignant potential. This study aimed to evaluate the oncologic and reproductive outcomes of patients with ovarian SCTs.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with ovarian SCTs who underwent surgery at Peking Union Medical College Hospital between January 2008 and August 2025. Patients were classified into fertility-sparing surgery (FSS) and non-FSS groups according to surgical approach. Clinical features, oncologic outcomes, hormonal recovery, and reproductive outcomes were analyzed.</p><p><strong>Results: </strong>Thirty patients were included, with 19 in the FSS group and 11 in the non-FSS group. The median age of patients was 27 (range: 4-42) in the FSS group and 55 (range: 25-80) in the non-FSS group (P < 0.001). In the FSS group, 63.2% (12/19) of patients had FIGO stage IA disease, 26.3% (5/19) had stage IC1 disease, and 10.5% (2/19) had stage II disease, whereas all patients in the non-FSS group had FIGO stage IA disease (P = 0.029). Elevated serum testosterone levels with virilizing manifestations were observed in all FSS patients and in 45.5% of non-FSS patients. No recurrence was observed among patients with FIGO stage IA disease in either group. Recurrences occurred in a patient with stage IC who underwent ovarian cystectomy and in two patients with stage II in the FSS group, one of whom died of disease. At the last follow-up, only one patient clearly reported an active desire for childbearing and subsequently achieved a spontaneous twin pregnancy with live birth. Median follow-up was 61 months (range: 6-184) in the FSS group and 67 months (range: 4-160) in the non-FSS group.</p><p><strong>Conclusion: </strong>Ovarian SCTs confined to FIGO stage IA were associated with favorable oncologic outcomes in our cohort, whereas recurrence occurred in patients with stage IC or II disease. For patients with stage IA disease desiring fertility preservation, unilateral salpingo-oophorectomy (USO) may be considered. Fertility preservation in stage IC or II disease should be individualized with caution. Long-term follow-up and multi-institutional studies are needed to better define both oncologic and reproductive outcomes.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological consistency and molecular heterogeneity in synchronous endometrial and ovarian carcinomas: a clinicopathological study within the FIGO 2023 framework.","authors":"Wenli Gan, Ce Bian, Jitong Zhao","doi":"10.1186/s13048-026-02213-8","DOIUrl":"10.1186/s13048-026-02213-8","url":null,"abstract":"<p><strong>Background: </strong>The 2023 International Federation of Gynecology and Obstetrics (FIGO) staging system introduced Stage IA3 to categorize a subset of synchronous endometrial and ovarian carcinomas (SEOC) with favorable outcomes. This study aims to evaluate the clinical and biological rationale of the FIGO 2023 Stage IA3 criteria by analyzing paired molecular profiles and assessing the prognostic impact of ovarian versus endometrial clinicopathological features.</p><p><strong>Methods: </strong>A retrospective cohort of 48 SEOC patients was evaluated and stratified into three cohorts: Group A (Stage IA3, n = 12), Group B (Advanced Concordant, n = 26), and Group C (Independent Discordant, n = 10). Survival outcomes were assessed alongside clinical interventions. Given the retrospective design, clonal relationships were assessed in a sub-cohort of 17 patients for whom complete paired immunohistochemistry (IHC) data for mismatch repair (MMR) proteins and p53 were available for both tumor sites.</p><p><strong>Results: </strong>Univariate analysis showed that ovarian factors, including histological grade and lymph node metastasis, were significantly associated with overall survival (OS, p < 0.01). In contrast, endometrial parameters, such as myometrial invasion (MI) depth and FIGO stage, did not show statistical significance (all p > 0.5). Group A had a 5-year OS of 90.9%, while Group B showed a 5-year OS of 95.5%, and Group C showed 70.0%. Among the 17 cases with paired IHC testing, molecular discordance was identified in 29.4% (5/17) overall, all of which occurred within the non-IA3 group, yielding a discordance rate of 38.5% (5/13 in non-IA3 group vs. 0% in Stage IA3 group). Notably, Case 29 exhibited concordant p53 mutational patterns but divergent MMR status between the endometrial and ovarian lesions.</p><p><strong>Conclusion: </strong>In conclusion, our preliminary findings suggest that the FIGO 2023 Stage IA3 classification defines a biologically consistent, low-risk cohort, offering a potential rationale for exploring future treatment de-escalation. Furthermore, paired molecular profiling (p53 and MMR) highlights the value of assessing tumor heterogeneity and clonal evolution for refined risk stratification. Clinical management may benefit from integrating molecular risk features to better distinguish true concordant SEOC from independent aggressive malignancies, particularly in histologically discordant cases.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Expression of Concern: Progesterone peak influences embryonic developmental morphokinetics on trigger day? A retrospective study.","authors":"D Baldini, V M Bartoli, A Mastrorocco, D Ferri, M Dellino, A S Laganà, S Hatirnaz, G M Baldini, A Malvasi, A Vimercati, G Trojano","doi":"10.1186/s13048-026-02235-2","DOIUrl":"https://doi.org/10.1186/s13048-026-02235-2","url":null,"abstract":"","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on multi-mechanism analysis and protection strategies of ovarian aging and fertility decline.","authors":"Jianhui Chen, Xiaohui Duan, Yaling Jing, Xiaofang Liu, Yongqiang Zhang, Yuqin Tang, Chuanliang Chen, Jiayan Yang, Xiaohong Li, Fang Lin, Lianfang Zhao","doi":"10.1186/s13048-026-02203-w","DOIUrl":"10.1186/s13048-026-02203-w","url":null,"abstract":"<p><p>Age-related fertility decline is an increasingly important challenge in reproductive medicine, driven largely by progressive ovarian aging. The aging ovary undergoes functional deterioration characterized by reduced ovarian reserve and declining oocyte quality, ultimately limiting female reproductive lifespan. Although multiple molecular and cellular processes associated with ovarian aging have been identified, these mechanisms are often discussed independently, limiting an integrated understanding of how they interact within the ovary. In this review, we propose an ovary-centered, multi-mechanistic framework to organize current evidence on ovarian aging and fertility decline. We discuss how genomic instability, telomere attrition, mitochondrial dysfunction, oxidative stress, chronic cellular stress responses, and alterations in ovarian signaling and microenvironmental homeostasis collectively contribute to follicle depletion and impaired oocyte competence. Particular emphasis is placed on signaling pathways involved in follicle activation and stress adaptation, including PI3K/AKT/mTOR, FOXO3, Hippo, and AMPK-Sirtuin networks, while acknowledging that many mechanistic relationships remain incompletely defined in physiological ovarian aging. Building on this integrative perspective, we further evaluate mechanism-oriented intervention strategies, including mitigation of cellular stress, metabolic and signaling modulation, optimization of the ovarian microenvironment, established fertility preservation technologies, and emerging exploratory approaches. By integrating current mechanistic and translational evidence, this review provides a conceptual framework for understanding ovarian aging and highlights future directions for evidence-based fertility preservation and reproductive health management in the context of aging.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The prognostic value of the Oocyte Maturation Index (OMI) on pregnancy outcomes in POSEIDON group 3 and 4 patients: a retrospective cohort study.","authors":"Yakup Bayram, Hamza Yildiz, Gorkem Ulger, Huseyin Durukan, Devrim Tok, Faik Gurkan Yazici","doi":"10.1186/s13048-026-02211-w","DOIUrl":"10.1186/s13048-026-02211-w","url":null,"abstract":"","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothalamic Epac2/AKT/GnRH signalling is associated with metformin-responsive neuroendocrine improvement in a PCOS model.","authors":"Na Guo, Hongyun Li, Jinhong He, Huanhuan Zhou, Xing Wang, Linlin Yang, Huijuan Ma","doi":"10.1186/s13048-026-02212-9","DOIUrl":"10.1186/s13048-026-02212-9","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a complex endocrine-metabolic disorder characterised by hypothalamic-pituitary-gonadal (HPG) axis dysfunction and pathological gonadotropin-releasing hormone (GnRH) hypersecretion. While metformin demonstrates therapeutic efficacy in PCOS, its potential neuroendocrine mechanisms remain incompletely understood. This study aimed to investigate the involvement of hypothalamic signalling in metformin-responsive neuroendocrine regulation in PCOS.</p><p><strong>Methods: </strong>Letrozole-induced PCOS rat models were treated with metformin to assess reproductive and metabolic outcomes. Data-independent acquisition (DIA) proteomics of hypothalamic tissue was performed to identify dysregulated pathways, followed by network analysis to explore candidate regulatory nodes. Mechanistic investigations were conducted in glucosamine-induced insulin-resistant GT1-7 GnRH neurons using pharmacological modulation and siRNA knockdown. In vivo functional relevance was examined using AAV-mediated Epac2 knockdown in the mouse arcuate nucleus.</p><p><strong>Results: </strong>Metformin improved metabolic and reproductive abnormalities in PCOS rats, including insulin resistance, GnRH/LH hypersecretion, estrous cyclicity disruption, and ovarian morphological alterations. Hypothalamic proteomic and network analyses suggested that metformin-responsive changes were associated with insulin and cAMP-related signalling pathways. In GT1-7 neurons, metformin increased Epac2 expression, restored AKT signalling, and reduced GnRH overproduction under insulin-resistant conditions. Hypothalamic Epac2 knockdown reduced AKT signalling and was associated with systemic insulin resistance, increased GnRH/LH secretion, and preliminary supportive ovarian morphological observations, consistent with a functional contribution of Epac2 to reproductive-metabolic regulation.</p><p><strong>Conclusions: </strong>These findings support the involvement of hypothalamic Epac2/AKT/GnRH signalling in metformin-responsive neuroendocrine regulation in PCOS. Further studies are required to determine the relative contributions of central and peripheral mechanisms.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lactylation-related transcriptional signature as candidate biomarkers for the early detection of polycystic ovary syndrome: an integrated genomic analysis.","authors":"Rui Wei, Hao Zhang, Wenting Xu, Changjiang Qin","doi":"10.1186/s13048-026-02208-5","DOIUrl":"https://doi.org/10.1186/s13048-026-02208-5","url":null,"abstract":"<p><strong>Background: </strong>Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder that negatively impacts women's reproductive and metabolic health, leading to complications such as irregular menstruation, infertility, obesity, and metabolic syndrome. Current diagnostic methods, which primarily rely on clinical symptoms and hormone levels, lack specificity in early detection. This study aimed to identify lactylation-related transcriptional signatures as candidate biomarkers for the early detection of PCOS.</p><p><strong>Methods: </strong>We conducted a comprehensive bioinformatic analysis using transcriptomic data from granulosa cells of PCOS patients in the GEO database. Patients were categorized into two molecular subtypes via consensus clustering based on the expression of lactylation-related genes. Subsequently, diagnostic models were constructed and validated to evaluate the potential of these transcriptional signatures as early diagnostic markers. External validation was performed using an independent dataset, and selected candidate genes were further examined in DHEA-treated KGN cells.</p><p><strong>Results: </strong>We identified nine key genes (HK3, SDC3, TGFBI, ZYX, LSP1, HMGA1, LCP1, B3GAT1, and ZNF280C) that were significantly differentially expressed in PCOS granulosa cell transcriptomic datasets. Pathway enrichment analyses revealed their involvement in energy metabolism, cell proliferation and apoptosis, which highlights their potential roles in PCOS pathogenesis. A random forest-based diagnostic model showed high internal predictive performance, with an ROC AUC of 0.993; however, external validation yielded a lower AUC of 0.628, indicating limited generalizability and the need for further validation.</p><p><strong>Conclusion: </strong>These findings suggest that lactylation-related transcriptional signatures may serve as potential candidate biomarkers for the early detection of PCOS. However, because this study was based primarily on transcriptomic inference and did not directly measure lactylation modifications, the results should be interpreted as hypothesis-generating. Future studies should validate these biomarkers in larger clinical cohorts, primary granulosa cells, and through direct lactylation or proteomic assays.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic immune and coagulation amplifiers resolve diagnostic ambiguity in endometriosis-associated ovarian cancer.","authors":"Li Luo, Yanwei Tu, Zirui Zhu, Mingzhu Ye","doi":"10.1186/s13048-026-02205-8","DOIUrl":"https://doi.org/10.1186/s13048-026-02205-8","url":null,"abstract":"<p><strong>Background: </strong>Preoperative discrimination between endometriosis-associated ovarian cancer (EAOC) and benign ovarian endometrioma (OE) remains challenging because imaging findings overlap and CA125 is frequently elevated by benign pelvic inflammation. We hypothesized that EAOC is associated with a systemic immune-coagulation signature that could improve risk stratification beyond tumor markers alone.</p><p><strong>Methods: </strong>We retrospectively analyzed treatment-naive patients who underwent primary surgery for ovarian masses between January 2015 and February 2025. EAOC (n = 49) and OE (n = 146) were confirmed histopathologically according to the Sampson-Scott criteria. Preoperative laboratory indices obtained within 2 weeks before surgery included fibrinogen, albumin, absolute monocyte count (AMC), CA125, and HE4; the fibrinogen-to-albumin ratio (FAR) was calculated. A multivariable logistic regression model integrating age, menopausal status, AMC, FAR, CA125, and HE4 was developed as the CO-MHF nomogram. Supplementary data-driven analyses included least absolute shrinkage and selection operator (LASSO) logistic regression, Akaike information criterion (AIC)-based stepwise selection, and add-one/drop-one marginal contribution analysis. Discrimination, calibration, and clinical utility were assessed by area under the receiver operating characteristic curve (AUC), bootstrap-derived confidence interval (CI), the Hosmer-Lemeshow test, and decision curve analysis (DCA).</p><p><strong>Results: </strong>FAR and AMC were significantly higher in EAOC than in OE (median FAR 0.10 versus 0.07; median AMC 0.39 versus 0.31 × 10⁹/L). The CO-MHF model showed favorable internal discrimination (AUC 0.932, 95% CI 0.887-0.968), outperforming HE4 (0.835), FAR (0.786), CA125 (0.769), and AMC (0.657). At the Youden-derived threshold (0.468), sensitivity was 75.5% and specificity 95.9%, with a positive predictive value (PPV) of 86.0% and a negative predictive value (NPV) of 92.1%. Lower thresholds increased sensitivity to 85.7%-93.9% at the cost of reduced specificity. Supplementary data-driven analyses supported the predictor set: AIC-based stepwise selection identified the same variables, and LASSO retained all CO-MHF predictors. Calibration was acceptable (Hosmer-Lemeshow P = 0.225), and DCA showed greater net benefit across a range of threshold probabilities.</p><p><strong>Conclusions: </strong>A mechanism-informed nomogram combining FAR and AMC with established tumor markers may improve preoperative risk stratification for EAOC. This host-response framework merits further evaluation in other malignancy-versus-inflammation diagnostic settings, although prospective multicenter validation and clinical threshold optimization remain necessary.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":"19 1","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-androgen therapy in polyendocrine metabolic ovary syndrome (PMOS, formerly PCOS): efficacy, safety, and phenotype-oriented clinical decision-making.","authors":"Hongfa Peng, Jingjing Jiang, Zhu Wang, Wei Wang","doi":"10.1186/s13048-026-02201-y","DOIUrl":"10.1186/s13048-026-02201-y","url":null,"abstract":"<p><p>Polyendocrine metabolic ovarian syndrome (PMOS, formerly polycystic ovary syndrome [PCOS]), hereinafter referred to as PMOS/PCOS, is the most prevalent endocrine metabolic disorder among women of reproductive age. It is characterized by a self-perpetuating cycle in which hyperandrogenemia (central in several, but not all, phenotypes) acts as the primary driver, exacerbating reproductive dysfunction, metabolic disturbances, and psychological distress. Anti-androgen therapy remains an important treatment for alleviating hyperandrogenism-related clinical signs, including hirsutism, acne, and female-pattern hair loss. In this review, we provided a comprehensive molecular analysis of hyperandrogenism in PMOS/PCOS, systematically evaluated the efficacy of key anti-androgen agents, including combined oral contraceptives, spironolactone, cyproterone acetate, finasteride, and emerging therapies, and assessed their safety profiles concerning metabolic, reproductive, and general adverse effects. We further examine integrated management strategies combining pharmacotherapy, lifestyle modifications, insulin sensitizers such as metformin, and emerging integrative approaches. Special considerations for adolescents, women planning pregnancy, and individuals with obesity are highlighted. This review also addressed current controversies, including uncertainties regarding long-term cardiovascular safety, optimal treatment duration, and the lack of predictive biomarkers, outlining future research priorities. Finally, we proposed a practical phenotype-guided framework for the stratified clinical management of hyperandrogenic PMOS/PCOS.</p>","PeriodicalId":16610,"journal":{"name":"Journal of Ovarian Research","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}