Most patients with polycystic ovary syndrome (PCOS) have insulin resistance, so what is insulin resistance, what are the effects on reproductive endocrinology, whether or not treatment is needed, how to treat it, etc., and today we discuss this. More than 95% of PCOS patients have sporadic ovulation or no ovulation, resulting in infertility rate as high as 50-80%, and ovulation assisted conception (OA) is a necessary means of treatment, but there are many potential risks for PCOS patients, such as: low sensitivity of ovulation assisted conception, high pregnancy rate, high rate of miscarriage, and high rate of pregnancy complications, etc., and insulin resistance is one of the most important factors contributing to these risks. How is insulin resistance diagnosed? Complaints: irregular menstruation, infertility. Signs: symptoms of hyperandrogenism such as hirsuteness, acne, obesity; and family history of diabetes. Based on the above, our doctors will initially consider whether the patient has insulin resistance, and recommend the patient to undergo the following tests: vaginal ultrasound, blood test (sex hormone 6), glucose tolerance test 9OGTT, insulin release test, to comprehensively determine whether the patient has polycystic ovary syndrome, insulin resistance, and its severity, and then provide individualized treatment. How does insulin resistance affect reproductive endocrinology? Insulin is the only hormone in the body that lowers blood glucose, enabling the body’s insulin-sensing tissues to absorb glucose to lower blood glucose levels, provide energy for the body, and also promote fat and protein synthesis. Insulin resistance is the inability of normal levels of insulin to trigger signals that induce glucose uptake by muscle and fat cells, and in order to compensate for this, the body releases large amounts of insulin in order to keep blood glucose levels stable. Excessive insulin will increase the synthesis and release of luteinizing hormone in the body, resulting in hyperandrogenism in the body and inhibiting ovulation; it will cause a localized hyperandrogenic state in the ovaries and inhibit the activity of follicle-stimulating hormone-related enzymes, resulting in the insensitivity of ovaries to the stimulation of FSH and ovulation-promoting drugs and the failure of ovulation-promoting treatment. Resistance causes: insulin resistance is generally common in obese people, especially abdominal obesity, most patients with polycystic ovary syndrome is also very common, some patients do not meet the indications of obesity, but simply high body fat percentage may also exist insulin resistance, insulin resistance can develop into complete type 2 diabetes mellitus, high-carbohydrate diets, infections, high levels of stress, smoking and exposure to second-hand smoke are all can exacerbate insulin resistance. From the perspective of fertility, if insulin resistance is diagnosed, active treatment is needed to improve the endocrine environment, which will help follicle development, maturation and ovulation, and increase the chances of conception. 2. From the perspective of glucose metabolism, active treatment is also needed because insulin resistance can develop into complete type 2 diabetes. Treatment: The treatment of insulin resistance is mainly carried out in three aspects: 1, diet control: reduce rice and starchy food, eat more fresh vegetables and protein-rich food. 2, exercise: reasonable exercise, and the development of a healthy body, and the development of a healthy body. Exercise: Reasonable exercise, control body mass index in the normal range. 3.Medication: such as oral metformin to increase insulin sensitivity. Some studies show that the therapeutic effect achieved through diet and exercise management is significantly better than drug treatment, we must pay attention to these two, do not rely only on pure drug treatment.