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Commentary: Emerging role of GIP and related gut hormones in fertility and PCOS

Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with infertility which affects one in ten women in the United Kingdom. Women with PCOS are typified by insulin resistance, gestational diabetes and obesity. Therefore, a close association between reproductive function and nutrition is postulated. However, regulatory pathways common to energy and reproductive function have received little attention. Recent research shows rapid amelioration of infertility, PCOS and type 2 diabetes following Roux-en-Y bariatric surgery (RYGB). This occurs prior to weight loss suggesting involvement of gut derived factors. Therefore, gut hormones emerge as key players in the regulation of both energy homeostasis and possibly reproductive function. Alteration of gut peptide levels including GLP-1, GIP, PYY, ghrelin, NPY and neurotensin post-bariatric surgery suggest a plausible mechanism behind beneficial effects of RYGB. Furthermore, expression of gut peptide receptors within the reproductive axis strengthen the idea of involvement of these hormones in the remission of fertility post-surgery. The present commentary discusses the role of these important gut peptides and their receptors in the regulation of female reproductive system in the light of a recent article published by our laboratory. Understanding the functional relationship between the gut and reproductive axis will help us to identify novel and less invasive alternatives to bariatric surgeries for reproductive and related metabolic disorders.