The relationship between polycystic ovary syndrome and infertility: a bibliometric analysis. Original paper

What was studied?

This study conducted a bibliometric analysis to elucidate the global research trends, collaborations, and evolving focal points regarding polycystic ovary syndrome (PCOS) and infertility. The authors systematically searched the Science Citation Index Expanded (SCI-E) database using the terms “polycystic ovary syndrome” and “infertility,” extracting all relevant literature up to September 21, 2021. The aim was to quantify publication outputs, citation trends, authorship, institutional and country contributions, journal significance, and the evolution of research keywords within this field. The bibliometric approach, utilizing CiteSpace software, enabled visualization of collaborations and shifts in research emphasis, offering an in-depth overview of the current landscape, gaps, and future directions in PCOS and infertility research.

Who was studied?

The study did not directly involve patient populations or experimental cohorts; rather, it analyzed 2,716 published documents (after deduplication) on PCOS and infertility. These documents encompassed original research articles, reviews, proceedings papers, editorials, and other scholarly outputs. The contributing researchers originated from 105 countries, with the United States, China, the United Kingdom, Italy, and Australia leading in publication volume. Institutional analysis highlighted the University of Adelaide, Monash University, and the University of Pennsylvania as key contributors. The analysis also identified top publishing authors, including Legro RS and Zhang HP, and mapped collaborative patterns across countries and institutions.

Most important findings

The bibliometric analysis revealed a consistent annual increase in both the number of publications and citations in the PCOS and infertility field, indicating growing scientific interest and knowledge generation. The United States dominated in terms of research output and collaborative centrality, while the University of Adelaide was the leading institution in both publication count and collaboration. Top journals such as Fertility and Sterility and Human Reproduction published the majority of studies, but highly impactful papers also appeared in comprehensive and endocrinology journals. Keyword analysis uncovered evolving research interests: in earlier years, focus centered on diagnostic criteria and ovulation induction; more recently, meta-analysis, follicular fluid, oxidative stress, and new therapeutic strategies gained prominence. Insulin resistance, obesity, and metabolic factors repeatedly emerged as key terms, reflecting the recognized metabolic-microbiome axis in PCOS.

Key implications

This study highlights the increasing global research activity in PCOS and infertility, but also exposes regional imbalances, with most research concentrated in developed countries. The evolving research focus toward metabolic, inflammatory, and therapeutic dimensions, many of which are intimately linked to the gut and reproductive tract microbiome, signals an opportunity for deeper integration of microbiome insights into PCOS research. The identification of key authors, institutions, and journals can inform clinicians and researchers seeking collaborative networks or authoritative sources. Additionally, the bibliometric trends help prioritize research questions and resource allocation, emphasizing the need for multicenter, international studies (especially in underrepresented regions) and for systematic evaluations of adjunctive therapies, including those targeting metabolic-microbiome pathways. For clinicians, understanding these trends supports evidence-based practice and highlights the emerging role of metabolic and potentially microbial factors in PCOS-related infertility.