Polycystic ovarian syndrome (PCOS) remains a common and challenging condition, which, depending on the diagnostic criteria, ethnicity, age, and other factors such as body weight affects approximately one in 10 (∼11–13%) of reproductive-aged women globally [1], [2], [3]. It is characterized by irregular menstruation, androgen excess and/or polycystic ovaries and is associated with infertility consequences, cardiometabolic and psychological abnormalities, and even harms men's health-related quality of life [1], [2], [3]. Management can vary according to age and individual needs. Optimal weight and lifestyle management (diet, exercise training, and behavior) are first-line therapy approaches for PCOS [4], [5].

Previous evidence has explored the role of aerobic exercises in improving cardiometabolic an reproductive health in overweight or obese women with PCOS [4]. The majority of the evidence showed regular exercise such as continuous exercises and high-intensity interval training (HIIT), depending on various intensities and volume of exercise can affect metabolic and hormonal parameters by increasing insulin sensitivity, cardiopulmonary function, and reducing BMI [6]. Many studies have explored the optimal intensity and duration of any type of exercise in some patients, for instance, studies illustrated guidelines for prescribing exercise in cardiac rehabilitation (CR) and demonstrated dose, duration, type, and absolute and relative contraindications to exercise in CR and disease [7], [8], [9]. Another study indicated the best intensity and type of exercise that should be implied in management of the diabetes type 2 [10]. Overall, clinical guidelines recommend exercise as the first line of therapy to manage PCOS [4]. In addition, based on these data, clinical practice guidelines recommend diet and regular exercise for weight control to manage PCOS in overweight individuals, but exercise guidelines including the type, intensity, duration frequency, and dose of exercise are not specified. Therefore, despite the large amount of research literature on the beneficial effects of various types of physical activity in the non-pharmacological management of infertility-related disorders in women with PCOS, there is still no objective exercise guideline for the implementation of various types of exercise in women with PCOS. With this in mind, whereas many studies and systematic reviews investigated the results of physical activity and exercise to manage PCOS [11], [12], [13], [14], there isn’t adequate research on prescribing and describing optimal protocol to these patients in detail. So, we first guide individuals in recognition of PCOS and its deleterious effects and briefly depict the mechanism underlying the effects of exercise on PCOS, and finally based on study results, the best exercise considering duration and intensity is prescribed for women with PCOS. Thus, according to previous research reports, the purpose of this review is to describe and provide prescriptions or guidelines for prescribing different exercise modality (aerobic, resistance, HIIT) in PCOS considering optimal duration, intensity, and repetition with suggested types of sports. It is important for individuals to know that which exercise modality (aerobic, resistance, HIIT) is most effective for improving metabolic and reproductive outcomes in PCOS?