Reviewer’s report
Title: 
The prevalence and phenotypic manifestations of polycystic ovary
syndrome (PCOS) among infertile Sudanese women: across-sectional study
Version: 
1 
Date: 
03 Mar 2022
Reviewer's report:
PEER REVIEWER ASSESSMENTS: 
OBJECTIVE - Full research articles: is there a clear objective that addresses a
testable research question(s) (brief or other article types: is there a clear
objective)?
No - there are major issues
DESIGN - Is the current approach (including controls and analysis protocols)
appropriate for the objective?
No - there are minor issues
EXECUTION - Are the experiments and analyses performed with technical rigor
to allow confidence in the results?
No - there are minor issues
STATISTICS - Is the use of statistics in the manuscript appropriate?
No - there are issues with the statistics in the study
INTERPRETATION - Is the current interpretation/discussion of the results
reasonable and not overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Is the current version of this work
technically sound? If not, can revisions be made to make the work technically
sound?
Maybe - with major revisions
PEER REVIEWER COMMENTS: 
GENERAL COMMENTS: 
The manuscript appears interesting and in line with the aims of the Journal.
Nevertheless, the authors should clarify some points and improve the discussion.
For these reasons, I recommended major revisions.
REQUESTED REVISIONS: 
I would recommend to take into account the following suggestions:
- the whole manuscript needs language revision by an English native speaker in
order to improve gramma and style.
- Introduction: accumulating evidence suggests that one of the most important
mechanisms of PCOS pathogenesis is the insulin-resistance. For this reason, the
use of insulin-sensitizers, such as inositol isoforms, gained increasing attention
due to their safety profile and effectiveness. Authors may better discuss this
point, taking into account these recent articles: PMID: 26927948; PMID:
27579037.
- Study population and sampling techniques: I actually think that PCOS
frequency of 50% in the population is a bit exaggerated. Authors should clarify
this point.
- Study population and sampling techniques: the authors declared they selected
PCOS population from a fertility center. This may represent a significant bias,
since I guess that women attending the clinic had fertility problems.
- Methods: did the authors follow the "STROCSS 2021" (Strengthening the
reporting of cohort, cross-sectional and case-control studies in surgery)? This
should be considered the gold standard guideline for cross-sectional studies.
- Results: authors declared that "Sudanese women uniquely expressed phenotype
D". Again, this is exaggerated, considering that only 51.6% of women were of
phenotype D.
- Discussion: I would suggest, at least briefly, current challenges for ovarian
stimulation in patients affected by PCOS (authors may refer to: PMID:
32418772; PMID: 30078122).
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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Is the use of statistics and treatment of uncertainties appropriate?
No
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No
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes