SynthesisFrontiers in endocrinology2026
Effects of probiotic and metformin co-administration versus metformin monotherapy on anthropometric measurements, hormones, and glucolipid profile in women with polycystic ovary syndrome: a systematic review and meta-analysis.
Synthesis in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Polycystic ovary syndrome (PCOS) often presents with insulin resistance and hormonal imbalances, metformin and probiotics are each effective treatments but the effect of combining both is unknown. Objective: To assess whether the addition of probiotics to metformin treatment further improves metabolic, hormonal and gastrointestinal effects in women with PCOS. Methods: PubMed, Web of Science, Scopus, and Google Scholar were searched for English-language articles until 2 December 2025. Two reviewers screened studies, extracted data and evaluated risk of bias independently. Random effects pooled effects were calculated when possible as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI). Results: Six studies were included; compared to metformin alone the addition of probiotics decreased insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR): MD -0.50, 95% CI -0.73 to -0.26; low-to-moderate heterogeneity) and borderline significantly lowered luteinizing hormone (LH) (SMD -0.56, 95% CI -1.11 to 0.01; substantial heterogeneity), there were also fewer metformin-induced gastrointestinal adverse effects with the addition of probiotics. Conclusions: There may be benefit to adding probiotics to metformin therapy for women with PCOS in improving insulin resistance and gastrointestinal tolerability as well as possibly decreasing LH. Heterogeneity between studies, short intervention duration and non-standardized probiotic doses/preparations limit the strength of these findings. Further study with larger, longer, randomized controlled trials that use a standardized probiotic formulation are needed. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251237018, identifier CRD420251237018.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.