The impact of age on clinical features and fertility outcomes in patients with polycystic ovary syndrome: a secondary analysis based on the PCOSAct trial

The clinical presentation of PCOS evolves significantly with advancing age. It is typically characterized by a shift from a state of hyperandrogenism and reproductive abnormalities in younger women to a profile increasingly dominated by progressive metabolic disturbances and cardiovascular risks in later years. Although ovulation response improves in older patients, they face a higher risk of early pregnancy loss. This underscores the necessity of implementing age-stratified clinical management for individuals with PCOS.