PREVALENCE OF METABOLIC SYNDROME AMONG INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME: A SYSTEMATIC REVIEW STRATIFIED BY DIAGNOSTIC CRITERIA

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with reproductive and metabolic disturbances. Metabolic syndrome (MetS) represents a significant comorbidity, particularly among infertile women with PCOS, increasing the risk of long-term cardiovascular and metabolic complications. Objective: To systematically review the prevalence of metabolic syndrome among infertile women with PCOS and examine associated metabolic and reproductive outcomes. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched up to December 2025. Studies assessing the prevalence of metabolic syndrome in women with PCOS were included. Ten observational studies met the inclusion criteria. Data were extracted on study characteristics, diagnostic criteria, prevalence rates, and associated risk factors. A narrative synthesis approach was used due to heterogeneity across studies. Results: The prevalence of metabolic syndrome among women with PCOS ranged from 1.7% to 58%. Higher prevalence was consistently associated with increasing age, body mass index, and central obesity. The most common metabolic abnormalities were low high-density lipoprotein cholesterol and increased waist circumference. Women with metabolic syndrome demonstrated greater metabolic risk profiles and required more intensive reproductive interventions. Although reproductive outcomes such as pregnancy rates were not significantly different, complications such as preeclampsia were more frequent. Conclusion: Metabolic syndrome is highly prevalent among infertile women with PCOS and is associated with adverse metabolic and reproductive outcomes. Early screening and integrated management strategies are essential to improve clinical outcomes and reduce long-term health risks.