A randomized trial combining acupuncture with clomiphene in obese PCOS patients demonstrated greater reductions in LH/FSH ratios and improved IR compared with clomiphene alone, alongside compositional changes in GM, including increased Agathobacter faecis and decreased Erysipelatoclostridium and Streptococcus species. This evidence concerns the gene PLOD1 and polycystic ovary syndrome.