Overweight and obese women with polycystic ovary syndrome (PCOS) may have a greater chance of becoming pregnant if they lose weight before beginning fertility treatment, according to an analysis of two studies funded by the National Institutes of Health. It is known that women’s fertility declines with age. These findings support delaying fertility treatment in women with PCOS, even when taking the age-related decline in fertility into account.
PCOS is a condition in which the ovaries often contain numerous small, cyst-like sacs. Along with infertility, symptoms may include obesity; irregular, missing or prolonged menstrual periods; and excessive facial and body hair. Women with PCOS also may experience insulin resistance, a pre-diabetic condition in which higher-than-normal amounts of insulin are produced to maintain normal blood glucose levels.
In one of the analyzed studies, 187 obese and overweight women with PCOS were immediately treated with clomiphene, a drug that induces ovulation. In the other study, 142 women with PCOS began a weight loss program consisting of lower caloric intake, exercise, and anti-obesity medication before starting clomiphene treatment. Women who were treated with clomiphene alone had an ovulation rate of 44.7 percent and a live birth rate of 10.2 percent. The women who received clomiphene after the weight loss program had a 62 percent ovulation rate and a 25 percent live birth rate.
Esther Eisenberg is study author and program director in the Fertility and Infertility Branch at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.