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1 Introduction Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age, with a global prevalence ranging from 11% to 13% based on the Rotterdam diagnostic criteria ( Growing evidence suggests that the gut microbiome plays a fundamental role in maintaining host metabolic, immune, and endocrine homeostasis ( Building upon these pathophysiological insights, recent clinical investigations have identified distinct gut microbial signatures in PCOS patients, characterized by reduced -diversity and specific taxonomic alterations that correlate with key clinical features ( 2 The gut-ovary axis The gut microbiota and ovaries engage in sophisticated bidirectional crosstalk through an integrated network of metabolic, immunologic, and neuroendocrine pathways

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