Exercise, dieting found to improve fertility in women with polycystic ovary syndrome

men who have the hormone disorder polycystic ovary syndrome may be able to improve their fertility through weight loss and exercise, according to the results of a new study.

The study assessed the impact of lifestyle modification on fertility in comparison with birth control pills.

Published in the Journal of Clinical Endocrinology & Metabolism, the study could be good news for the estimated 5 million women across the US that have polycystic ovary syndrome (PCOS), the most common cause of female infertility.

The findings confirm what the researchers at Penn State College of Medicine in Hershey, PA have long suspected - that exercise and a healthy diet can improve fertility in women who have PCOS.

PCOS can occur when women produce more male hormones, such as testosterone, than normal and can lead to the formation of fluid-filled sacs known as cysts on the ovaries. Symptoms of the condition include pelvic pain, excess hair growth, weight gain and acne, as well as irregular menstrual periods and infertility.

At present, women with PCOS may be prescribed birth control pills to regulate hormone production. Previous studies have demonstrated that short-term courses of birth control pills can improve fertility in women with the condition.

In this new open-label study, the researchers aimed to compare different interventions for PCOS - including the birth control pill - assessing the impact they had on fertility.

A total of 149 women with PCOS were randomly assigned to one of three intervention groups. One group was prescribed birth control pills, one group underwent lifestyle modification consisting of dieting, exercise and weight-loss medication, and one group underwent a combination of the two interventions. Each group undertook their mode of intervention for 4 months.

The participants in the study were all 18-40 years old and were either overweight or obese - a known risk factor for both PCOS and female infertility - but otherwise healthy.

Lifestyle changes 'important' for overweight, obese women with PCOS

After the 4-month intervention period had been completed, each participant underwent four cycles of ovulation induced by medication.

The researchers found that five of the 49 women in the birth control pill group gave birth. In comparison, 13 of the 50 women in the lifestyle modification group and 12 of the 50 women in the combination intervention group delivered babies.

Combining birth control pills with lifestyle modification had several beneficial outcomes. The women who undertook this intervention were more likely to ovulate than those who were solely prescribed birth control pills, while also having better insulin sensitivity and lower levels of triglycerides in the blood.

"The research indicates preconception weight loss and exercise improve women's reproductive and metabolic health. In contrast, using oral contraceptives alone may worsen the metabolic profile without improving ovulation. Lifestyle change is an important part of any fertility treatment approach for women with PCOS who are overweight or obese."

As all the participants in the study were overweight or obese, it remains to be seen whether or not lifestyle modification in the form of regular exercise and adhering to a healthy diet is effective at improving fertility among women with PCOS who already have a healthy weight.

Despite a potential limitation to the study, the research team promotes this lifestyle intervention. "Making preconception lifestyle changes is beneficial, either alone or in combination with other pretreatment options," they conclude.

References:

1.  A randomized controlled trial of preconception interventions in infertile women with polycystic ovary syndrome, Richard S. Legro et al., Journal of Clinical Endocrinology & Metabolism, doi: 10.1210/jc.2015-2778, published online 24 September 2015, abstract.
2.  Endocrine Society news release, accessed 23 September 2015 via Newswise.
3.  Additional source: Mayo Clinic, Female infertility - risk factors, accessed 23 September 2015.
4.  Additional source: Mayo Clinic, Polycystic ovary syndrome (PCOS) - treatments and drugs, accessed 23 September 2015.
5.  Additional source: MedlinePlus, Polycystic ovary syndrome, accessed 23 September 2015.