Zhang D, et al. - In women with polycystic ovary syndrome (PCOS), researchers assessed the impacts of hyperinsulinemia and insulin resistance (IR) on reproductive and metabolic disorders and fertility. Participants in the study were 1,000 women at 21 sites (27 hospitals) diagnosed with PCOS according to the modified Rotterdam criteria. The analysis between hyperinsulinemia and IR and clinical features demonstrated that weight, waist and hip circumference, BMI, waist-to-hip ratio, acanthosis nigricans score, and menstrual period were significantly linked to fasting insulin (FIN) and HOMA-IR. No significant association was found between the hirsutism score or acne score with FIN or HOMA-IR. Total testosterone and free testosterone, increasing serum insulin levels and HOMA-IR were significantly linked to reduced cycle ovulation, conception, pregnancy and live birth rates after adjustments for age. In PCOS patients, hyperinsulinemia and IR were linked to reproductive and metabolic disorders and can anticipate the fertility results as seen in this multicenter, randomized controlled trial.