Four Subtypes of Polycystic Ovary Syndrome Identified

MONDAY, Nov. 3, 2025 (HealthDay News) — Four subtypes of polycystic ovary syndrome (PCOS) have been identified, according to a study published online Oct. 29 in Nature Medicine.

Xueying Gao, from Shandong University in Jinan, China, and colleagues examined commonly measured variables that could distinguish clinical subtypes of PCOS using unsupervised clustering of nine clinical variables in 11,908 affected women. The subtypes were validated in five independent cohorts. The association between reproductive and metabolic variables in different subtypes was examined during a follow-up of 6.5 years.

The researchers identified four PCOS subtypes: PCOS with hyperandrogen, with obesity, with high-sex hormone-binding globulin, and with high-luteinizing hormone-anti-Müllerian hormone. Distinctive reproductive and metabolic trajectories were seen on prospective follow-up and with in vitro fertilization treatment data: The highest risk for second-trimester pregnancy loss and dyslipidemia incidence was seen for hyperandrogenic PCOS; PCOS with obesity showed the most severe metabolic complications, lowest live birth rates, and highest PCOS remission rate; favorable reproductive outcomes and the lowest incidence of diabetes and hypertension were seen for PCOS with high sex-hormone-binding globulin; and the highest risk for ovarian hyperstimulation and the lowest PCOS remission rate was seen for PCOS with high-luteinizing hormone-anti-Müllerian hormone.

“This international collaboration has provided robust evidence that could change how we diagnose, treat, and follow up on women with PCOS. It also emphasizes that treatment can be tailored to the PCOS subtype to better capture the biological variation in PCOS,” coauthor Elisabet Stener-Victorin, from the Karolinska Institutet in Stockholm, said in a statement.

One author disclosed ties to the biopharmaceutical industry.

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