Farname Inc. in collaboration with Iranian Society of Gynecology Oncology

Authors

1 lecturer of obstetrics and gynecology-tanta university

2 ass.profeesor of obstetrics and gynecology-tanta university

3 assistant professor obstetrics and gynecology-tanta university

Abstract

Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.
Study design: A prospective observational study.
Patients: 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 5 days for 6 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 in responder group  and It was found that despite there was statistical difference between both group as regard weight gain , weight after 6 months and  BMI after 6 months , there was no significant difference between both groups as regard  the ovulation rate , pregnancy rate and complications to ovulation induction (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 this results.
 

Keywords

  1. 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. Endocrine Practice. 2015; 11, 1291–300. 2. Legro RS., Richard S. Benefit of delayed fertility therapy with preconception weight loss over immediate therapy in obese women with PCOS. The Journal of Clinical Endocrinology & Metabolism.2016; 101 (7): 2658-2666. 3. Georgios K., GinaT., Neoklis A. Diet and exercise in the management of PCOS: Starting from the basics. Polycystic Ovary Syndrome :Challenging Issues in the Modern Era of Individualized Medicine. 2022; chapter 7: 97-115. 4. Goyal M, Dawood AS. Debates regarding lean patients with polycystic ovary syndrome: A narrative review. Journal of human reproductive sciences.2017; 10(3), 154. 5. Olga N., Simona F. The role of dietitian in the multidisciplinary treatment of PCOS. Nutrition, Metabolism and Cardiovascular Diseases.2022: 32; 827-832. 6. Francisco Á. , José I., José L. Prevalence and Characteristics of the Polycystic Ovary Syndrome in Overweight and Obese Women.Arch Intern Med. 2006;166(19):2081-2086. doi:10.1001/archinte.166.19.2081. 7. Nermine N. , Reham F. , Maysa S. , Saneya A. Body Weight Concern and Belief among Adolescent Egyptian Girls. Maced J Med Sci. 2018 Mar 15; 6(3): 582–587. doi: 10.3889/oamjms.2018.145. 8. Vikrant G., Shwetha P., Harpreet K. Assessment of clinical, biochemical, and hormonal profile of lean versus overweight polycystic ovarian syndrome patients: A cross-sectional study. journal of internal medicine . 2022 : 10 ; Issue : 1 ; 13-16. 9. Bindu K., Neera Sh., Shubhi P., Lokesh Sh., Bhawna P. PCOS patients differ in meal timings rather than total caloric or macronutrient intake in comparison to weight matched controls. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2022: 270; 11-16. 10. Akshaya S., Bhattacharya R. Comparative study of clinical profile of lean and obese polycystic ovary syndrome women. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2016; Vol. 5, Issue 8. 11. Kathleen M. Obesity and Lifestyle Management in Polycystic Ovary Syndrome.Clinical Obstetrics and Gynecology: 2007; 50(1): 277-294. 12. Lisa J. , Catherine B. , Siew L. Polycystic Ovary Syndrome and Weight Management. SAGE journals ;2010 ; https://doi.org/10.2217/WHE.09.89 13. Sehar T. , Ravinder S., Joseph M. Lean polycystic ovary syndrome (PCOS): an evidence-based practical approach. J Diabetes Metab Disord. 2018 ; 17(2): 277–285. 14. Luigi B., Evelyn F.,Ludovica V., Florencia C., Gabriela C., Eloisa G.PCOS and nutritional approaches: Differences between lean and obese phenotype.Metabolism Open. 2021; Volume 12, 100-123. 15. W. Vitek, F. Sun , K.M. Hoeger , M. Diamond , H. Zhang , R.S. Legro. Weight gain during ovulation induction among women with polycystic ovary syndrome and unexplained infertility. Fertility And Sterility .2018; VOLUME 110, ISSUE 4; DOI:https://doi.org/10.1016/j.fertnstert.2018.07.207. 16. Adam B., Platteau P., Andersen A. N. The influence of body weight on response to ovulation induction with gonadotrophins in 335 women with World Health Organization group II anovulatory infertility. BJOG International Journal of Obstetrics & Gynaecology. 2006; 113(10):1195-202.