Iranian Society of Gynecology Oncology

Document Type : Original Research Article


Department of Obstetrics and Gynecology, Tanta University, Tanta, Egypt


Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.
Material and methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with Letrozole 2.5 mg twice daily for five days for six cycles. Ovulation and pregnancy rates were assessed.  
Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated to the responder group, and it was found that despite there was statistical difference between both groups as regard weight gain, weight after six months and BMI after six months, there was no significant difference between both groups as regard the ovulation rate, pregnancy rate and complications to ovulation induction ovarian hyperstimulation syndrome (OHSS).
Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of these results.


Main Subjects

1. Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: Guide to the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome - Part 1. Endocr Pract. 2015;21(11):1291-300. [DOI:10.4158/EP15748.DSC] [PMID]
2. Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, et al. Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS. J Clin Endocrinol Metab. 2016;101(7):2658-66. [DOI:10.1210/jc.2016-1659] [PMID] [PMCID]
3. Markantes GK, Tsichlia G, Georgopoulos NA. Chapter 7 - Diet and exercise in the management of PCOS: Starting from the basics. In: Diamanti-Kandarakis E, editor. Polycystic Ovary Syndrome: Elsevier; 2022. p. 97-115. [DOI:10.1016/B978-0-12-823045-9.00010-9]
4. Goyal M, Dawood AS. Debates Regarding Lean Patients with Polycystic Ovary Syndrome: A Narrative Review. J Hum Reprod Sci. 2017;10(3):154-61. [DOI:10.4103/jhrs.JHRS_77_17] [PMID] [PMCID]
5. Nemchikova O, Frontoni S. The role of dietitian in the multidisciplinary treatment of PCOS. Nutr Metab Cardiovasc Dis. 2022;32(4):827-32. [DOI:10.1016/j.numecd.2022.01.003] [PMID]
6. Álvarez-Blasco F, Botella-Carretero JI, San Millán JL, Escobar-Morreale HF. Prevalence and Characteristics of the Polycystic Ovary Syndrome in Overweight and Obese Women. Arch Intern Med. 2006;166(19):2081-6. [DOI:10.1001/archinte.166.19.2081] [PMID]
7. Mahfouz NN, Fahmy RF, Nassar MS, Wahba SA. Body Weight Concern and Belief among Adolescent Egyptian Girls. Open Access Maced J Med Sci. 2018;6(3):582-7. [DOI:10.3889/oamjms.2018.145] [PMID] [PMCID]
8. Ghatnatti V, Patil S, Kour H. Assessment of Clinical, Biochemical, and Hormonal Profile of Lean Versus Overweight Polycystic Ovarian Syndrome Patients: A Cross-Sectional Study. J Intern Med. 2022;10(1):13-6. [DOI:10.4103/ajim.ajim_117_20]
9. Kulshreshtha B, Sharma N, Pant S, Sharma L, Pahuja B, Singh P. PCOS patients differ in meal timings rather than total caloric or macronutrient intake in comparison to weight matched controls. Eur J Obstet Gynecol Reprod Biol. 2022;270:11-6. [DOI:10.1016/j.ejogrb.2021.12.023] [PMID]
10. Akshaya S, Bhattacharya R. Comparative study of clinical profile of lean and obese polycystic ovary syndrome women. Int j Reprod Contracept Obstet Gynecol. 2016;5(8):2530-4. [DOI:10.18203/2320-1770.ijrcog20162173]
11. Hoeger KM. Obesity and lifestyle management in polycystic ovary syndrome. Clin Obstet Gynecol. 2007;50(1):277-94. [DOI:10.1097/GRF.0b013e31802f54c8] [PMID]
12. Moran LJ, Lombard CB, Lim S, Noakes M, Teede HJ. Polycystic Ovary Syndrome and Weight Management. Women's Health. 2010;6(2):271-83. [DOI:10.2217/WHE.09.89] [PMID]
13. Toosy S, Sodi R, Pappachan JM. Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord. 2018;17:277-85. [DOI:10.1007/s40200-018-0371-5] [PMID] [PMCID]
14. Barrea L, Frias-Toral E, Verde L, Ceriani F, Cucalón G, Garcia-Velasquez E, et al. PCOS and nutritional approaches: Differences between lean and obese phenotype. Metabol Open. 2021;12:100123. [DOI:10.1016/j.metop.2021.100123] [PMID] [PMCID]
15. Vitek W, Sun F, Hoeger KM, Santoro N, Diamond M, Zhang H, Legro RS. Weight gain during ovulation induction among women with polycystic ovary syndrome and unexplained infertility. Fertil Steril. 2018;110(4):e68. [DOI:10.1016/j.fertnstert.2018.07.207]
16. Balen AH, Platteau P, Andersen AN, Devroey P, Sørensen P, Helmgaard L, Arce JC. The influence of body weight on response to ovulation induction with gonadotrophins in 335 women with World Health Organization group II anovulatory infertility. BJOG. 2006;113(10):1195-202. [DOI:10.1111/j.1471-0528.2006.01034.x] [PMID]