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Table 1 Summary of major microbiome studies involving PCOS

From: Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review

Country diagnostic criteria Sample groups Sequencing diversity change Microbial composition change
Kelley 2016 [50] USA NA Letrozole-induced PCOS mouse model/placebo 16S rDNA sequencing
↓α diversity
β diversity:
PCoA of the UniFrac distances: a significant shift
↑Lachnospiraceae, Erysipelotrichaceae, Ruminococcacea
↑Allobaculum, Blautia, and Ruminococcus
↓S24–7 and 1 in the family Rikenellaceae, genus Alistipes
Guo Y 2016 [7] China NA Letrozole-treated rats (n = 24)/control (n = 8) 16S rDNA sequencing
NA ↓Lactobacillus, Ruminococcus, and Clostridium
Lindheim 2017 [18] Austria Rotterdam Criteria PCOS (n = 24)/control (n = 19) 16S rDNA sequencing
↓α diversity
β diversity:
Unweighted UniFrac analysis: significant clustering
↓Phylum Tenericutes, the order ML615J-28 (belonging to the phylum Tenericutes)
↓Family S24–7 (belonging to the phylum Bacteroidetes)
Liu 2017 [18] China Rotterdam Criteria PCOS (non obese PCOS,n = 12; obese PCOS,n = 21)/controls (n = 9 non obese control;n = 6 obese control) 16S rDNA sequencing V3–4 ↓α diversity
β diversity:
CO group was more similar with that of PN and PO groups, rather than CN group
↑LPS-producing bacteria
↓Spore forming species
↓Akkermensia (of the phylum Verrucomicrobia) and Alistipes, Corprococcus, Ruminococcus
Torres 2018 [20] Poland Rotterdam Criteria Women with PCOM (n = 42)/control healthy women
(n = 48)/women with PCOS (n = 73)
16S rDNA sequencing V4 ↓α diversity in women with PCOS compared with healthy women
β diversity was correlated with hyperandrogenism
↑Porphyromonas spp., Bacteroides coprophilus, Blautia spp., Faecalibacterium prausnitzii in women with PCOS compared with healthy women
Insenser 2018 [21] Spain Rotterdam Criteria PCOS (n = 15)/16 non hyperandrogenic control women (n = 16) and control men (n = 15) 16S rDNA sequencing V4 ↓α diversity in women compared with men
↓β diversity in obese patients with PCOS compared with their lean counterparts
↑Catenibacterium, Kandleria genera
Zeng 2018 [22] China Rotterdam Criteria IR-PCOS (n = 9, PCOS with insulin resistance),
NIR-PCOS (n = 8, PCOS alone), and healthy controls (n = 8)
16S rDNA sequencing V3–4 ↓α diversity in IR-PCOS compared to healthy controls
β diversity(weighted UniFrac and PCoA analysis):samples from the HC group can be clearly discriminated from the IR-PCOS group
↑Prevotellaceae in IR-PCOS and NIR-PCOS compared to healthy controls
↑Bacteroides in IR-PCOS and NIR-PCOS compared to healthy controls
2018 [84]
USA NA Model of prenatal androgen exposure rats/maternal hyperandrogenemia by single-injection of testosterone cypionate or sesame oil vehicle 16S rDNA sequencing ↑α diversity in PNA animals
β diversity:
the PNA animal samples were further apart.
↑Nocardiaceae and Clostridiaceae
↓Akkermansia, Bacteroides, Lactobacillus, and Clostridium
Zhang 2019 [52] China NA PCOS (n = 38)/control (n = 26) 16S rDNA sequencing V3-V4, deep shotgun metagenomic sequencing β diversity:
weighted and unweighted UniFrac analysis:
significant clustering
↓Faecalibacterium, Bifidobacterium, and Blautia
↑Parabacteroides, Bacteroides, Lactobacillus, Oscillibacter, Escherichia/ Shigella, and Clostridium
Chen 2019 [98] China Chinese Criteria
non⁃acne PCOS patients(n = 10), MSA⁃PCOS,n = 10)/ healthy controls (n = 10) 16S rDNA sequencing
↓α diversity
β diversity:
weighted UniFrac analysis:samples from the HC group can be clearly discriminated from PCOS
↓Prevotella, Faecalibacteruim
Zhou 2020 [99] China Rotterdam Criteria obese PCOS (OG,n = 30), non-obese PCOS (NG,N = 30) /healthy women (NC,n = 30) healthy but obese women (OC,n = 11) 16S rDNA sequencing
α diversity: Simpson index of OTU: NG was significantly higher than that in NC
β diversity: No significant difference
↑OG:Lactococcus, Paraprevotella, Alloprevotella
↑NG:Coprococcus_2, Lactobacillus, Prevotella_7
Qi 2019 [53]   NA PCOS (n = 50)/control (n=43) Whole-genome shotgun sequencing α diversity:no significant
↑Bacteroides vulgatus