Fig. 1

Recruitment and screening process of cases. A total of 13 patients met the inclusion criteria, but one patient was excluded because they had taken metformin within the past 6 months. Of the remaining 12 patients, four dropped out and did not complete the treatment. Among the eight samples obtained after 3 months of metformin treatment, three failed to be sequenced. Finally, five cases of PCOS-IR were collected. PCOS, polycystic ovary syndrome; IR, insulin resistance; HOMA-IR, homeostatic model assessment for insulin resistance; EVs, extracellular vesicles