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 Researchers compared pregnancy outcomes for 150 women with
polycystic ovary syndrome (PCOS), a condition that occurs when the
female body makes higher than normal amounts of testosterone and
androgens, sex hormones associated with male traits.
Among three groups of women, those who exercised lost the most
weight and had more live births than those who didn’t.
Women with PCOS often experience irregular menstrual cycles, weight
gain, excess hair on the face and body and infertility. They may
take birth control pills to boost female hormones and regulate
ovulation for several months before trying to get pregnant. This is
thought to improve their odds of success once they stop taking
contraceptives and start trying to conceive.
For the first four months of the study, one third of the women took
birth control pills for that purpose, while a second group was
directed to exercise and follow a low-calorie diet. A third group
got both of these interventions.
After that initial phase, women taking contraceptives stopped. At
this point all of the women went through four cycles of medically
induced ovulation, designed to help them get pregnant.
Among 49 women in the initial birth control group, five had babies.
That compared with 13 babies for the 50 women assigned to diet and
exercise at the start of the study and 12 infants for women who got
a combination of both interventions.
The study was too small to show a statistically meaningful
difference in pregnancy outcomes between the two groups who dieted
and exercised, the authors acknowledge in the Journal of Clinical
Endocrinology and Metabolism.
But the results suggest that exercise and weight loss might play a
bigger role in conception than just regulating ovulation with birth
control pills before trying to conceive, said lead study author Dr.
Richard Legro of Pennsylvania State College of Medicine in Hershey.
“Based on our study, women with PCOS who are obese would derive the
greatest improvement in their quality of life and reproductive
parameters (body hair, androgen levels, polycystic ovaries and
control of menstrual bleeding) with maintenance of their metabolic
health through the combination of oral contraceptives with lifestyle
modification and weight loss,” Legro said by email.
All of the women in the study were overweight or obese, which is
linked to fertility problems regardless of whether women have PCOS.
Women who exercised during the study lost significantly more weight
than the group assigned only to birth control pills.
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At the same time, the women only taking contraceptives were more
likely to develop a condition known as metabolic syndrome, a cluster
of conditions including high blood sugar that have been linked to
fertility challenges as well as heightened risk for problems such
heart disease and diabetes.
As many as one in 10 women of childbearing age may have PCOS,
according to the U.S. Department of Health and Human Services. The
cause is unknown, but the condition is thought to be influenced by
many factors, including genetics, with PCOS more likely in women who
have an afflicted mother or sister.
While the findings confirm some earlier research linking metabolic
changes achieved though lifestyle improvements to better
reproductive function, weight loss can still be a tricky
prescription, noted Dr. Gordon Wright Bates Jr., a specialist in
reproductive endocrinology and infertility at the University of
Alabama at Birmingham.
Women with PCOS who come to a weight-loss clinic at his university
can struggle to achieve significant changes even when they are
making the effort to conceive, Bates, who wasn’t involved in the
study, said by email.
“Although the study adds considerable evidence to support lifestyle
modifications and weight loss to optimize reproductive potential and
the response to treatment, both of these remain elusive for many
patients,” Bates said.
SOURCE: http://bit.ly/1POq5KM Journal of Clinical Endocrinology and
Metabolism, online September 24, 2015.
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