Metabolic Dysregulation and Female Infertility: A Systematic Review of Hormonal and Reproductive Outcomes From Recent Clinical Trials.

This systematic review explores the influence of metabolic and immunological interventions on hormonal and fertility outcomes in infertile women with metabolic disorders such as polycystic ovary syndrome (PCOS), insulin resistance, obesity, and metabolic syndrome. The review synthesizes findings from rigorously selected randomized and crossover trials published between 2015 and 2024, focusing on interventional approaches aimed at improving reproductive and endocrine parameters. Studies were screened and assessed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and relevant outcomes included ovulation, oocyte quality, pregnancy rates, and changes in hormonal markers, such as insulin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol. The analysis reveals that metabolic dysregulation significantly alters reproductive outcomes and that targeted interventions, ranging from pharmacological agents and dietary modifications to experimentally induced metabolic states, can have measurable effects on hormonal profiles and fertility. While some interventions demonstrated clear improvements in ovulatory and metabolic markers, others primarily highlighted associations rather than causality. Despite variations in sample sizes and methodological designs, the review underscores the need for integrated therapeutic strategies addressing both metabolic and hormonal dysfunction in this population. The findings support a multifaceted approach to managing infertility in women with metabolic disturbances, emphasizing the potential for tailored interventions to optimize both endocrine and reproductive health.