Biomarkers for effective prognosis of polycystic ovary syndrome: a full review

Polycystic ovary syndrome (PCOS) is a complicated endocrine condition marked by reproductive, metabolic and chronobiological perturbations. Despite a number of biomarkers that can be used in its diagnosis, they only show the existence of the syndrome and not much information about prognosis. This prognostic blindness complicates disease management and contributes to increased healthcare and economic burden.

The review summarizes the literature on prognostic biomarkers in PCOS, including hormone biomarkers, metabolic biomarkers, circadian regulatory biomarkers, and non-coding RNAs. Clinical, observational, and preclinical findings indicate that these markers reflect early molecular and cellular perturbations, disease progression, and vulnerability to reproductive and metabolic issues.This review primarily focuses ondiagnostic and prognostic biomarkers associated with PCOS, highlighting their relevance in early detection, disease stratification, and risk assessment. Therapeutic biomarkers are discussed only where they offer mechanistic or clinical insight into disease progression.

The combination of endocrine, metabolic, circadian, and RNA-based biomarkers offers a dynamic approach to PCOS prognostication. These biomarkers can improve the early diagnosis of high-risk patients, individual interventions, and reproductive and metabolic management. Future research should focus on validating these markers in large cohorts and developing predictive models to support clinical decision-making beyond static diagnostic criteria.