Female infertility due to polycystic ovary syndrome: Evidence-based diagnosis and personalized management: Literature review

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic condition that impacts fertility, menstrual cycle, metabolism, and women's quality of life, requiring early diagnosis and individualized management. Furthermore, physiotherapeutic interventions have been shown to be relevant in controlling musculoskeletal symptoms and optimizing reproductive function. Objective: To conduct a bibliographic review on evidence-based diagnosis, clinical and pharmacological management, and individualized strategies for female infertility associated with PCOS, emphasizing multidisciplinary interventions, hormonal therapies, lifestyle modifications, continuous follow-up, and the incorporation of physiotherapy aimed at improving mobility, strength, and pelvic function. Methods: Descriptive and analytical bibliographic review based on national and international publications available in the Virtual Health Library (BVS), LILACS, PubMed, and Scopus databases. Studies published between 2019 and 2025, in Portuguese and English, were included, encompassing reviews, clinical studies, narrative studies, observational studies, clinical trials, and case reports. Interviews, isolated opinion reports, and duplicate materials were excluded. The selection process was carried out in three stages: identification, screening of titles and abstracts, and full-text reading of eligible studies. Results: The literature indicates that integrated approaches combining pharmacological interventions (letrozole, metformin, semaglutide), lifestyle modifications, nutritional support, psychological follow-up, and continuous monitoring promote improved fertility, menstrual cycle regulation, anovulation control, and reduction of metabolic complications. Treatment adherence, health education, and multidisciplinary support are determinants for better clinical, reproductive, and psychosocial outcomes. Barriers include delayed diagnosis, unequal access to specialized services, and partial adherence to therapies. Additionally, physiotherapy stands out as a complementary strategy, through aerobic and resistance exercises and pelvic floor strengthening, contributing to body weight reduction, improved insulin sensitivity, relief of pelvic and lower back pain, optimization of reproductive function, and enhancement of quality of life. Physiotherapeutic intervention reinforces multidisciplinary care, integrating with medical and nutritional treatment. Conclusion: Effective management of infertility in women with PCOS depends on individualized, evidence-based strategies supported by clinical protocols, pharmacological interventions, lifestyle modifications, multidisciplinary follow-up, and physiotherapeutic interventions targeting pelvic function and physical rehabilitation. Investments in health education, professional training, and integration of care pathways are essential to optimize clinical, metabolic, and reproductive outcomes.