Efficacy of probiotic and synbiotic supplementation on metabolic and endocrine parameters in PCOS: a meta-analysis of RCTs
Probiotic and synbiotic supplementation significantly reduced fasting insulin, total testosterone, triglycerides, LDL-c, BMI, and body weight in women with PCOS, with no significant effect on fasting glucose, HOMA-IR, or gonadotropins.
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What the study showed
Meta-analysis of 11 RCTs (780 participants) showed statistically significant reductions in fasting insulin, total testosterone, triglycerides, LDL-c, BMI, and body weight, alongside increases in HDL-c and total antioxidant capacity. No significant effects were found for fasting glucose, HOMA-IR, QUICKI, FSH, LH, or SHBG.
How it was done
Systematic review with searches in PubMed, Web of Science, Cochrane Library, and Embase through March 2026; quality assessed with RoB 2.0; analyses performed with RevMan 5.4 and Stata 17.0; prospectively registered in PROSPERO.
Risk of bias
Only 11 RCTs with 780 participants constrain statistical power and generalizability. Heterogeneity in strains, doses, duration, and synbiotic composition is not quantified in the abstract.
What this study does NOT prove
This meta-analysis does not prove that probiotics improve fertility, menstrual regularity, or clinically meaningful insulin resistance in women with PCOS.
In clinical practice
Effect sizes are statistically significant but modest; the evidence base is narrow and insufficient to support routine clinical recommendation outside research settings.
Limitations
Only 11 RCTs with 780 participants constrain statistical power and generalizability. Heterogeneity in strains, doses, duration, and synbiotic composition is not quantified in the abstract.
Technical appendix
Version history
- 1.0 · 2026-07-15 — Auto-generated under Evidence Standard v1.0
Paid access: structured summary from public metadata; consult the original study at the source.