The impact of anogenital distance on vaginal and anal microbiota in women with polycystic ovary syndrome and its implications for pregnancy outcomes

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting women of reproductive age, yet its etiopathogenesis remains poorly understood. There is ongoing debate regarding the diagnostic criteria for PCOS, with various clinical biomarkers proposed but none achieving widespread acceptance. This study investigated anogenital distance (AGD) and its relationship with microbiota in women with PCOS. Significant differences in AGD were observed between PCOS patients and a control group, with notable variations in anal microbiota. Specifically, relative abundances of Faecalibacterium and Gardnerella differed significantly between the two groups. The clinical pregnancy rate per embryo transfer was higher in the control group, indicating potentially poorer reproductive outcomes in the PCOS group. AGD metrics (AGD_ AC and AGD_ AF ) were identified as predictors of clinical pregnancy outcomes, with optimal cutoff values of 87.2 mm and 26.7 mm, respectively. These results provide initial evidence that AGD and microbiota may play roles in reproductive health in PCOS, warranting further research to validate these associations and explore their implications for treatment and prevention strategies in affected individuals.