METABOLIC AND REPRODUCTIVE SUBTYPES OF POLYCYSTIC OVARY SYNDROME AND THEIR CLINICAL SIGNIFICANCE

Authors

DOI:

https://doi.org/10.11603/24116-4944.2025.2.15794

Keywords:

polycystic ovary syndrome, insulin resistance, hyperandrogenism, hirsutism, hormonal profile, mature oocytes, anti-Müllerian hormone, reproductive outcomes, dermatological markers

Abstract

The aim of the study – to evaluate the clinical, dermatological, and hormonal characteristics of different subtypes of polycystic ovary syndrome (PCOS) and determine their relationship with the effectiveness of controlled ovarian stimulation.

Materials and Methods. 90 women with PCOS were studied, divided into two groups: metabolic subtype (PCOS combined with metabolic syndrome, n=46) and reproductive subtype (pure PCOS, n=44). Ovarian stimulation parameters (duration, gonadotropin dose, number of oocytes, MII fraction, ovarian sensitivity index – OSI), hormonal profile (LH, FSH, LH/FSH, estradiol, prolactin, total and free testosterone, AMH) and dermatological signs of hyperandrogenism were analyzed.

Results and Discussion. The metabolic subtype of PCOS was characterized by a significantly higher frequency of dermatological manifestations of hyperandrogenism: hirsutism was found in 73.91 % of patients (1.5 times more often than in pure PCOS), and acanthosis nigricans – in 43.48 % (2.7 times more often). The average hirsutism score was 1.4 times higher. These changes were accompanied by an increase in total and free testosterone, LH, LH/FSH ratio, and AMH. Patients with the metabolic subtype had worse ovarian response parameters: the duration of stimulation was longer, and ovarian sensitivity index was 1.34 times lower. The proportion of mature MII oocytes was reduced (62.4 % vs. 74.7 %), indicating a deterioration in the quality of folliculogenesis against the background of metabolic disorders.

Conclusions. The metabolic subtype of PCOS is associated with more pronounced dermatological manifestations of hyperandrogenism, more severe hormonal disorders, and reduced ovarian response. The presence of acanthosis nigricans and high hirsutism scores can be considered clinical predictors of less favorable ovarian sensitivity to controlled ovarian stimulation and a lower proportion of mature oocytes. The results obtained emphasize the need for a personalized approach to the treatment of patients with PCOS, taking into account their subtype.

Author Biographies

S. V. Khmil, I. Horbachevsky Ternopil National Medical University

Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology No.1

Yu. B. Pravak, I. Horbachevsky Ternopil National Medical University

Postgraduate (PhD) student of the Department of Obstetrics and Gynecology No.1

S. O. Halnykina, I. Horbachevsky Ternopil National Medical University

Doctor of Medical Sciences, Professor of the Department of Infectious Diseases and Epidemiology, Dermatology and Venereology

A. S. Khmil Doswald, I. Horbachevsky Ternopil National Medical University Medical center “The Clinic of Professor Stefan Khmil”, Ternopil, Ukraine

PhD (Medicine), Assistant Professor of the Department of Obstetrics and Gynecology No.1

 

M. S. Khmil, I. Horbachevsky Ternopil National Medical University Medical center “The Clinic of Professor Stefan Khmil”, Ternopil, Ukraine

Candidate of Medical Sciences (PhD, Medicine), Associate Professor of the Department of Obstetrics and Gynecology No.1

References

Baba, T. (2025). Polycystic ovary syndrome: Criteria, phenotypes, race and ethnicity. Reproductive medicine and biology, 24(1), e12630. DOI: 10.1002/rmb2.12630. DOI: https://doi.org/10.1002/rmb2.12630

Dokras, A., Luque-Ramírez, M., & Escobar-Morreale, H.F. (2025). Polycystic ovary syndrome: origins and implications: Long-term health outcomes in polycystic ovary syndrome. Reproduction (Cambridge, England), 170(2), e250118. DOI: 10.1530/REP-25-0118. DOI: https://doi.org/10.1530/REP-25-0118

Mahoney, A., & D’Angelo, A. (2025). Treatment Options for Managing Anovulation in Women with PCOS: An Extensive Literature Review of Evidence-Based Recommendations for Future Directions. Life (Basel, Switzerland), 15(6), 863. DOI: 10.3390/life15060863 DOI: https://doi.org/10.3390/life15060863

Geisthövel, F., & Rabe, T. (2007). The ESHRE/ASRM consensus on polycystic ovary syndrome (PCOS) – an extended critical analysis. Reproductive biomedicine online, 14(4), 522-35. DOI: 10.1016/s1472-6483(10)60902-9. DOI: https://doi.org/10.1016/S1472-6483(10)60902-9

Teede, H.J., Tay, C.T., Laven, J.J.E., Dokras, A., Moran, L.J., Piltonen, T. ... & Joham, A.E. (2023). Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism, 108(10), 2447-69. DOI: 10.1210/clinem/dgad463. DOI: https://doi.org/10.1210/clinem/dgad463

Gao, X., Zhao, S., Du, Y., Yang, Z., Tian, Y., Zhao, J., et al. (2025). Data-driven subtypes of polycystic ovary syndrome and their association with clinical outcomes. Nature medicine, 10.1038/s41591-025-03984-1. Advance online publication. DOI: 10.1038/s41591-025-03984-1. DOI: https://doi.org/10.1038/s41591-025-03984-1

Abusailik, M.A., Muhanna, A.M., Almuhisen, A.A.,

Alhasanat, A.M., Alshamaseen, A.M., Bani Mustafa, S.M., & Nawaiseh, M.B. (2021). Cutaneous manifestation of polycystic ovary syndrome. Dermatology reports, 13(2), 8799. DOI: 10.4081/dr.2021.8799. DOI: https://doi.org/10.4081/dr.2021.8799

Gainder, S., & Sharma, B. (2019). Update on Management of Polycystic Ovarian Syndrome for Dermatologists. Indian dermatology online journal, 10(2), 97-105. DOI: 10.4103/idoj.IDOJ_249_17. DOI: https://doi.org/10.4103/idoj.IDOJ_249_17

Taieb, A., & Feryel, A. (2024). Deciphering the Role of Androgen in the Dermatologic Manifestations of Polycystic Ovary Syndrome Patients: A State-of-the-Art Review. Diagnostics (Basel, Switzerland), 14(22), 2578. DOI: 10.3390/diagnostics14222578. DOI: https://doi.org/10.3390/diagnostics14222578

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Published

2026-01-08

How to Cite

Khmil, S. V., Pravak, Y. B., Halnykina, S. O., Khmil Doswald, A. S., & Khmil, M. S. (2026). METABOLIC AND REPRODUCTIVE SUBTYPES OF POLYCYSTIC OVARY SYNDROME AND THEIR CLINICAL SIGNIFICANCE. Actual Problems of Pediatrics, Obstetrics and Gynecology, (2), 28–31. https://doi.org/10.11603/24116-4944.2025.2.15794

Issue

No. 2 (2025)

Section

OBSTETRICS AND GYNECOLOGY

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Copyright (c) 2025 С. В. Хміль, Ю. Б. Правак, С. О. Галникіна, А. С. Хміль Досвальд, М. С. Хміль

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