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Therapy with probiotics and synbiotics for polycystic ovarian syndrome: a systematic review and meta-analysis

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A Correction to this article was published on 11 March 2022

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Abstract

Objective

Several randomized controlled trials (RCTs) have investigated the use of probiotic/synbiotic in PCOS patients, without clarifying the real use in clinical practice. The aim of this meta-analysis was to evaluate the effectiveness of probiotics and synbiotics on metabolic, hormonal and inflammatory parameters of PCOS.

Methods

Electronic databases (MEDLINE, Scopus, EMBASE, ScienceDirect, The Cochrane Database of Systematic Reviews and ClinicalTrials.gov) were searched from their inception until May 2019. The study protocol was registered in PROSPERO with number CRD42018111534. Randomized controlled trials (RCTs) of PCOS’s women undergoing therapy at least 8 weeks with probiotics or synbiotics or without therapy were included. The primary outcomes were changes in anthropometric parameters, glucose/insulin metabolism, lipid profile, sex hormones profile, inflammation markers.

Results

587 patients were included in nine RCT. The administration of probiotic/synbiotic were associated with a significant improvement in FPG, FBI, HOMA I-R, BMI. It also modified Ferriman-Gallway, serum triglycerides, serum testosterone, hs-CRP, NO, TAC, GSH, and MDA. Subgroup analysis of the type of intervention showed that probiotics were associated with greater testosterone and FPG reduction; synbiotics administration resulted in a more pronounced decrease of the FBI. Subgroup analyses on the duration of therapy showed that, probiotic/synbiotic administration had a significantly greater effect on QUICK-I in the case of women with 12-weeks of therapy than in the 8-weeks therapy group. Nevertheless, we did not observe any significant difference was observed in terms of FBI, HOMA-IR, and FPG.

Conclusions

Probiotics and synbiotics seem to either an effect on/influence metabolic, hormonal and inflammatory parameters, or can influence them. Consequently, it could lead to an improvement of fertility in PCOS.

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Funding

No financial support was received for this study.

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Authors and Affiliations

  1. IVIRMA, IVI Foundation, Valencia, Spain

    Mauro Cozzolino, Livia Pellegrini & Nicolas Garrido

  2. Rey Juan Carlos University, Madrid, Spain

    Mauro Cozzolino

  3. Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA

    Mauro Cozzolino

  4. Unit of Gynaecology and Obstetrics, Department of Women and Children’s Health, University of Padua, Padua, Italy

    Amerigo Vitagliano, Alessandra Andriasani & Guido Ambrosini

  5. Department of Clinical Medicine and Surgery, “Federico II”, Medical School University, Naples, Italy

    Martina Chiurazzi

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  1. Mauro Cozzolino
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Contributions

MC designed the study, performed the literature search, defined inclusion criteria and selected studies for inclusion, participated in data extraction, performed the risk of bias assessment, performed the statistical analysis, and wrote the first and final drafts of the manuscript; AV designed the study, performed the literature search, performed the risk of bias assessment, performed the statistical analysis, and wrote final drafts of the manuscript; LP performed the literature search, selected studies for inclusion; MC performed the literature search; AA participated in the statistical analysis; GA critically revised the manuscript; NC critically revised the manuscript, participated in assessing the risk of bias within studies and the grading of evidence.

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Correspondence to Mauro Cozzolino.

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Cozzolino, M., Vitagliano, A., Pellegrini, L. et al. Therapy with probiotics and synbiotics for polycystic ovarian syndrome: a systematic review and meta-analysis. Eur J Nutr 59, 2841–2856 (2020). https://doi.org/10.1007/s00394-020-02233-0

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  • DOI: https://doi.org/10.1007/s00394-020-02233-0

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