Study on the Association Between the Systemic Immune-Inflammation Index and Polycystic Ovary Syndrome in Women Undergoing in vitro Fertilization for Subfertility
Li H,Tang H,Wang M,Guan H,Tang L,Chen X
International journal of women's health, 18, 625630, 2026
Polycystic ovary syndrome (PCOS) is closely associated with chronic low-grade inflammation. Systemic immune-inflammation index (SII) based on complete blood cell count has shown superior discriminative value in a variety of diseases, but its role in PCOS is still unclear. This study aimed to investigate the association between SII and PCOS in women undergoing their first in vitro fertilization (IVF) treatment with a gonadotropin-releasing hormone (GnRH) antagonist protocol.
Materials and Methods
A total of 334 women undergoing their first IVF treatment with a GnRH antagonist protocol from January 2019 to December 2025 were included in this study. They were divided into the PCOS group (n=160) and the non-PCOS group (n=174). Demographic and physical indicators, reproductive endocrine indicators, systemic inflammatory indicators, infertility situation, ovulation induction treatment parameters, and trigger day indicators were collected. Binary logistic regression was used to identify the independent associated factors of PCOS.
Results
The results of the multivariate analysis indicated that anti-Mullerian hormone (AMH) (OR=1.437, 95% CI: 1.222-1.690, P<0.001), basal follicle-stimulating hormone (FSH) (OR=0.718, 95% CI: 0.519-0.993, P=0.046), luteinising hormone (LH) (OR=1.293, 95% CI: 1.100-1.519, P=0.002), testosterone (T) (OR=14.533, 95% CI: 2.162-97.677, P=0.006), SII (OR=2.030, 95% CI: 1.079-3.819, P=0.028), and LH level on the trigger day (OR=1.284, 95% CI: 1.061-1.554, P=0.010) were independently associated with PCOS.
Conclusion
Among patients undergoing their first IVF treatment, SII was independently associated with PCOS. This further supported the crucial role of chronic low-grade inflammation in the pathophysiology of PCOS. In the future, its efficacy needs to be verified through large-scale studies. Before it is fully confirmed, it is not recommended to use it as an independent clinical tool.
Wang M et al., 2023·Environmental Science & Technology
Microplastic fibers from textiles have been known to significantly contribute to marine microplastic pollution. However, little is known about the microfiber formation and discharge during textile production. In this study, we have quantified microfiber emissions from one large and representative textile factory during different stages, spanning seven different materials, including cotton, polyester, and blended fabrics, to further guide control strategies. Wet-processing steps released up to 25 times more microfibers than home laundering, with dyeing contributing to 95.0% of the total emissions. Microfiber release could be reduced by using white coloring, a lower dyeing temperature, and a shorter dyeing duration. Thinner, denser yarns increased microfiber pollution, whereas using tightly twisted fibers mitigated release. Globally, wet textile processing potentially produced 6.4 kt of microfibers in 2020, with China, India, and the US as significant contributors. The study underlined the environmental impact of textile production and the need for mitigation strategies, particularly in dyeing processes and fiber choice. In addition, no significant difference was observed between the virgin polyesters and the used ones. Replacing virgin fibers with recycled fibers in polyester fabrics, due to their increasing consumption, might offer another potential solution. The findings highlighted the substantial impact of textile production on microfiber released into the environment, and optimization of material selection, knitting technologies, production processing, and recycled materials could be effective mitigation strategies.
The relationship between symptoms of premenstrual syndrome (PMS) and serum levels of pregnenolone (Pe), pregnenolone sulfate (PS), 5 alpha-pregnane-3,20-dione (5 alpha-DHP), 3 alpha-hydroxy-5 alpha- pregnan-20-one (5 alpha-THP), LH, 17 beta-estradiol (E2), and progesterone (P) was investigated during 2 consecutive menstrual cycles in 12 patients using daily measurements. Corresponding hormones were also measured during 1 cycle in 8 control women. Pe, PS, 5 alpha-DHP, and 5 alpha-THP showed a significant cyclicity within menstrual cycles and a high rate of correlation with P variation in both PMS patients and controls. No significant difference was found between PMS patients and controls in average serum concentrations of Pe, PS, 5 alpha-DHP, 5 alpha-THP, and LH during the luteal phase, whereas a significantly higher level of E2 and a lower level of P were observed in PMS patients. The variation in symptom scores was compared with that in hormone levels within each woman. The symptom peak showed a delay of 3-4 days after the serum P, Pe, 5 alpha-DHP, and 5 alpha-THP peaks. However, the plasma PS peak appeared on the same day or only 1 day before the symptom peak in PMS patients. When comparing the 2 cycles studied, more negative symptoms occurred in cycles with higher luteal phase E2, Pe, and PS concentrations, whereas higher luteal phase 5 alpha-DHP and 5 alpha-THP concentrations were associated with improved symptom ratings in PMS patients. These results suggest that the mentioned steroids are related to the severity of distressing symptoms in PMS patients.
Chen S et al., 2026·International journal of women's health
Polycystic ovary syndrome (PCOS) is a heterogeneous reproductive, endocrine, and metabolic disorder in which autonomic, neuroendocrine, inflammatory, and metabolic abnormalities may converge on ovarian and endometrial function. This narrative review evaluates evidence relevant to acupuncture in PCOS, with emphasis on evidence source, directness, and clinically meaningful reproductive outcomes. PubMed, Embase, and Web of Science were searched from inception to March 31, 2026, supplemented by backward citation tracking. We prioritized human PCOS trials and mechanistic studies, followed by PCOS-specific preclinical evidence; findings from other conditions were included only as explicitly labeled indirect evidence. No formal risk-of-bias assessment or meta-analysis was undertaken. Clinical evidence most consistently suggests possible effects on menstrual or ovulatory function, sympathetic activity, and insulin resistance, although results vary across protocols and PCOS phenotypes. Evidence for pregnancy, ongoing pregnancy, embryo quality, and live birth remains limited and inconsistent, and acupuncture has not been established as a substitute for guideline-based fertility treatment. Human data directly linking acupuncture to immune-cell reprogramming, endometrial immune tolerance, or correction of window-of-implantation timing are scarce. PCOS-specific animal studies provide plausible signals involving hypothalamic-pituitary-ovarian regulation, ovarian sympathetic signaling, inflammatory pathways, oxidative stress, and insulin signaling, but these findings cannot be assumed to translate to clinical reproductive benefit. Overall, the neuroendocrine-immune framework is best viewed as a hypothesis-guiding map that distinguishes relatively supported clinical domains from preclinical and indirect mechanisms. Future trials should combine standardized acupuncture protocols with phenotype stratification, prespecified ovulation, ongoing-pregnancy, and live-birth outcomes, and longitudinal autonomic, metabolic, inflammatory, ovarian, and endometrial measurements.
Kalyan S et al., 2017·Sci Rep·Free full text on PubMed Central
Chronic inflammation predisposes to poor bone health. Women with polycystic ovary syndrome (PCOS) experience androgen excess, ovulatory disturbances, insulin resistance, abdominal adiposity and chronic inflammation. Our objective was to investigate the relationships among bone health parameters, chronic subclinical inflammation and anthropometric measures in premenopausal women with and without PCOS. In 61 premenopausal women, 22 women with PCOS and 39 controls, we assessed bone parameters (total hip bone mineral density [BMD] by dual-energy X-ray absorptiometry and radius strength-strain index [SSI] by peripheral quantitative computed tomography), inflammation (C-reactive protein/albumin), oxidative stress (leukocyte telomere length, urinary 8-hydroxydeoxyguanosine); hemoglobin A1c; anthropometric measures (body mass index, waist-to-height ratio, cross-sectional muscle area). A diagnosis of PCOS negatively predicted (beta = -0.251, p = 0.022) hip BMD in a regression model including weight. In women with PCOS, inflammation, which was predicted by increased waist-to-height ratio and current use of oral contraceptives, attenuated the positive influences of increased weight and muscle mass on bone strength and was inversely associated with radial SSI (R(2) = 0.25, p = 0.018). In conclusion, chronic subclinical inflammation may negatively impact bone physiology in women with PCOS. Strategies focused on reducing abdominal adiposity and avoiding medications that increase inflammation may counter this effect.
Napolean N et al., 2026·Cureus·Free full text on PubMed Central
Background Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic disorder characterized by reproductive, hormonal, and metabolic disturbances. This study aimed to evaluate the association between clinical features, anthropometric indices, hormonal parameters, metabolic profile, ultrasonographic findings, and the second-to-fourth digit (2D:4D) ratio in women with PCOS compared to age-matched healthy controls. Methods A case-control study was conducted, including women diagnosed with PCOS and age-matched healthy controls. Clinical features, anthropometric measurements (BMI, waist-hip ratio (WHR), waist-height ratio (WHtR)), hormonal parameters (luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH)), metabolic variables (fasting glucose, lipid profile), ultrasonographic findings, and 2D:4D digit ratio were assessed. Statistical analysis was performed using appropriate tests, and a p-value < 0.05 was considered statistically significant. Results Women with PCOS exhibited a significantly higher prevalence of menstrual irregularity, polycystic ovarian morphology, hirsutism, and acne (p < 0.001). Hormonal analysis showed significantly elevated LH, FSH, and AMH levels in PCOS cases (p < 0.001). Anthropometric indices, including BMI, WHR, and WHtR, were significantly higher among PCOS cases (p < 0.01), indicating increased general and central adiposity. In contrast, fasting glucose and lipid profile levels did not differ significantly between groups. Additionally, the 2D:4D ratio was significantly lower in PCOS cases (p < 0.01) and showed significant negative correlations with BMI, WHR, WHtR, and cholesterol levels. Conclusion The study demonstrates that PCOS is associated with significant hormonal dysregulation, central obesity, and early metabolic alterations. The lower 2D:4D ratio observed in PCOS supports the role of prenatal androgen exposure in disease pathogenesis. These findings highlight the complex interplay between developmental, metabolic, and endocrine factors in PCOS and underscore the importance of early identification and comprehensive management strategies.
Jiang N et al., 2026·Frontiers in immunology·Free full text on PubMed Central
Polycystic ovary syndrome (PCOS), a complex endocrine and metabolic disorder, involves significant dysregulation of the immune system. Natural killer (NK) cells, as key components of innate immunity, demonstrate notable phenotypic and functional alterations in women with PCOS. These changes include not only an elevated proportion in peripheral blood but also dynamic shifts within the local microenvironments of the ovary and endometrium. The increased level of peripheral NK cells correlates with a chronic low-grade inflammatory state, potentially serving as a predictive marker in infertile PCOS patients. Within the endometrium, uterine NK (uNK) cells exhibit reduced numbers and impaired function, accompanied by dysregulation of cytokine networks such as IL-15 and IL-18, which disrupts the immune equilibrium essential for embryo implantation. Abnormal NK cell function further involves alterations in killer immunoglobulin-like receptor (KIR) repertoires and dysregulated secretion of angiogenic factors, thereby compromising endometrial receptivity and vascular remodeling. Hyperandrogenemia modulates the distribution and activity of NK cells in reproductive tissues by influencing their surface activation markers, while insulin resistance promotes the generation of myeloid-feature NK (myNK) cell subsets via the IL-6/Stat3 signaling pathway, collectively exacerbating metabolic inflammation and reproductive dysfunction. Deciphering the role of NK cells in the immunometabolic interplay of PCOS reveals their position as a critical link between. May represent a potential cutoff requiring validation in larger cohorts reproductive impairment and metabolic disturbances, opening new avenues for targeted immunomodulatory interventions. Collectively, NK cells appear to present an important immunometabolic link between reproductive dysfunction and metabolic disturbance in PCOS, highlight their potential relevance as therapeutic targets.
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