Human Reproduction, Vol. 10, No. 10, pp. 2705-2712, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women
1Reproductive Medicine Unit, Department of Obstetrics and Gynaecology, University of Adelaide 2Departments of Psychiatry 3Departments of Dietetics 4Departments of he Queen Elizabeth Hospital, Woodville SA 5011, Australia
Correspondence: 5To whom correspondence should be addressed
Obesity can affect ovulation and the chances of pregnancy. In this prospective study, a weight loss programme was assessed to determine whether it could help infertile overweight anovulatory women to establish ovulation and assist in achieving pregnancy, ideally without further medical intervention. The subjects acted as their own historical controls. They underwent a weekly programme of behavioural change in relation to exercise and diet over 6months; those who did not complete the 6 months were treated as the comparison group. Women in the study group lost an average of 6.3 kg, with 12 of the 13 subjects resuming ovulation and 11 becoming pregnant, five of these spontaneously. Fitness, diet and psychometric measurements all improved. Fasting insulin and testosterone concentrations dropped significantly, while sex hormone binding globulin concentrations rose. None of these changes occurred in the comparison group. Thus, weight loss with a resultant improvement in ovulation, pregnancy outcome,self-esteem and endocrine parameters is the first therapeutic option for women who are infertile and overweight.
Key words: obesity/ovulation/pregnancy/self-esteem/weight loss
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S.L. Gudmundsdottir, W.D. Flanders, and L.B. Augestad Physical activity and fertility in women: the North-Trondelag Health Study Hum. Reprod., December 1, 2009; 24(12): 3196 - 3204. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Nardo, A. P. Yates, S. A. Roberts, P. Pemberton, and I. Laing The relationships between AMH, androgens, insulin resistance and basal ovarian follicular status in non-obese subfertile women with and without polycystic ovary syndrome Hum. Reprod., November 1, 2009; 24(11): 2917 - 2923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Vahratian and Y. R. Smith Should access to fertility-related services be conditional on body mass index? Hum. Reprod., July 1, 2009; 24(7): 1532 - 1537. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hammerli, H. Znoj, and J. Barth The efficacy of psychological interventions for infertile patients: a meta-analysis examining mental health and pregnancy rate Hum. Reprod. Update, May 1, 2009; 15(3): 279 - 295. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Metwally, S. Amer, T.C. Li, and W.L. Ledger An RCT of metformin versus orlistat for the management of obese anovulatory women Hum. Reprod., April 1, 2009; 24(4): 966 - 975. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Maheshwari, G. Scotland, J. Bell, A. McTavish, M. Hamilton, and S. Bhattacharya The direct health services costs of providing assisted reproduction services in overweight or obese women: a retrospective cross-sectional analysis Hum. Reprod., March 1, 2009; 24(3): 633 - 639. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.E. Nieuwenhuis-Ruifrok, W.K.H. Kuchenbecker, A. Hoek, P. Middleton, and R.J. Norman Insulin sensitizing drugs for weight loss in women of reproductive age who are overweight or obese: systematic review and meta-analysis Hum. Reprod. Update, January 1, 2009; 15(1): 57 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Hoeger, K. Davidson, L. Kochman, T. Cherry, L. Kopin, and D. S. Guzick The Impact of Metformin, Oral Contraceptives, and Lifestyle Modification on Polycystic Ovary Syndrome in Obese Adolescent Women in Two Randomized, Placebo-Controlled Clinical Trials J. Clin. Endocrinol. Metab., November 1, 2008; 93(11): 4299 - 4306. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Thomson, J. D. Buckley, M. Noakes, P. M. Clifton, R. J. Norman, and G. D. Brinkworth The Effect of a Hypocaloric Diet with and without Exercise Training on Body Composition, Cardiometabolic Risk Profile, and Reproductive Function in Overweight and Obese Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., September 1, 2008; 93(9): 3373 - 3380. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Elkind-Hirsch, O. Marrioneaux, M. Bhushan, D. Vernor, and R. Bhushan Comparison of Single and Combined Treatment with Exenatide and Metformin on Menstrual Cyclicity in Overweight Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2670 - 2678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Franks, J. Stark, and K. Hardy Follicle dynamics and anovulation in polycystic ovary syndrome Hum. Reprod. Update, May 22, 2008; (2008) dmn015v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Veleva, A. Tiitinen, S. Vilska, C. Hyden-Granskog, C. Tomas, H. Martikainen, and J. S. Tapanainen High and low BMI increase the risk of miscarriage after IVF/ICSI and FET Hum. Reprod., April 1, 2008; 23(4): 878 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Palomba, F. Giallauria, A. Falbo, T. Russo, R. Oppedisano, A. Tolino, A. Colao, C. Vigorito, F. Zullo, and F. Orio Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study Hum. Reprod., March 1, 2008; 23(3): 642 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. O. Yildiz, E. S. Knochenhauer, and R. Azziz Impact of Obesity on the Risk for Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., January 1, 2008; 93(1): 162 - 168. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Maheshwari, L. Stofberg, and S. Bhattacharya Effect of overweight and obesity on assisted reproductive technology a systematic review Hum. Reprod. Update, September 1, 2007; 13(5): 433 - 444. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G.F. Homan, M. Davies, and R. Norman The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review Hum. Reprod. Update, May 1, 2007; 13(3): 209 - 223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D.C. Gesink Law, R.F. Maclehose, and M.P. Longnecker Obesity and time to pregnancy Hum. Reprod., February 1, 2007; 22(2): 414 - 420. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. E. Blaine, J. Rodman, and J. M. Newman Weight Loss Treatment and Psychological Well-being: A Review and Meta-analysis J Health Psychol, January 1, 2007; 12(1): 66 - 82. [Abstract] [PDF]
|
|
|
|
 |
|
 R. Pasquali and A. Gambineri Insulin-sensitizing agents in polycystic ovary syndrome. Eur. J. Endocrinol., June 1, 2006; 154(6): 763 - 775. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tang, J. Glanville, N. Orsi, J. H. Barth, and A. H. Balen The use of metformin for women with PCOS undergoing IVF treatment Hum. Reprod., June 1, 2006; 21(6): 1416 - 1425. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Franks Diagnosis of Polycystic Ovarian Syndrome: In Defense of the Rotterdam Criteria J. Clin. Endocrinol. Metab., March 1, 2006; 91(3): 786 - 789. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tang, J. Glanville, C. J. Hayden, D. White, J. H. Barth, and A. H. Balen Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome. A randomized, placebo-controlled, double-blind multicentre study Hum. Reprod., January 1, 2006; 21(1): 80 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. F. Escobar-Morreale, J. I. Botella-Carretero, F. Alvarez-Blasco, J. Sancho, and J. L. San Millan The Polycystic Ovary Syndrome Associated with Morbid Obesity May Resolve after Weight Loss Induced by Bariatric Surgery J. Clin. Endocrinol. Metab., December 1, 2005; 90(12): 6364 - 6369. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. E. Messinis Ovulation induction: a mini review Hum. Reprod., October 1, 2005; 20(10): 2688 - 2697. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Boivin and G Pennings Parenthood should be regarded as a right Arch. Dis. Child., August 1, 2005; 90(8): 784 - 785. [Full Text] [PDF]
|
|
|
|
 |
|
 Z. T. Bloomgarden Second World Congress on the Insulin Resistance Syndrome: Mediators, pediatric insulin resistance, the polycystic ovary syndrome, and malignancy Diabetes Care, July 1, 2005; 28(7): 1821 - 1830. [Full Text] [PDF]
|
|
|
|
|
|
S. Palomba, F. Orio Jr., A. Falbo, F. Manguso, T. Russo, T. Cascella, A. Tolino, E. Carmina, A. Colao, and F. Zullo Prospective Parallel Randomized, Double-Blind, Double-Dummy Controlled Clinical Trial Comparing Clomiphene Citrate and Metformin as the First-Line Treatment for Ovulation Induction in Nonobese Anovulatory Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., July 1, 2005; 90(7): 4068 - 4074. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.A. Checa, A. Requena, C. Salvador, R. Tur, J. Callejo, J.J. Espinos, F. Fabregues, J. Herrero, and (Reproductive Endocrinology Interest Group of the Insulin-sensitizing agents: use in pregnancy and as therapy in polycystic ovary syndrome Hum. Reprod. Update, July 1, 2005; 11(4): 375 - 390. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.M. de Liz and B. Strauss Differential efficacy of group and individual/couple psychotherapy with infertile patients Hum. Reprod., May 1, 2005; 20(5): 1324 - 1332. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Jayagopal, E. S. Kilpatrick, S. Holding, P. E. Jennings, and S. L. Atkin Orlistat Is as Beneficial as Metformin in the Treatment of Polycystic Ovarian Syndrome J. Clin. Endocrinol. Metab., February 1, 2005; 90(2): 729 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. N. Wade and J. E. Jones Neuroendocrinology of nutritional infertility Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2004; 287(6): R1277 - R1296. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Palomba, F. Orio Jr., L. G. Nardo, A. Falbo, T. Russo, D. Corea, P. Doldo, G. Lombardi, A. Tolino, A. Colao, et al. Metformin Administration Versus Laparoscopic Ovarian Diathermy in Clomiphene Citrate-Resistant Women with Polycystic Ovary Syndrome: A Prospective Parallel Randomized Double-Blind Placebo-Controlled Trial J. Clin. Endocrinol. Metab., October 1, 2004; 89(10): 4801 - 4809. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. J. Moran, M. Noakes, P. M. Clifton, G. A. Wittert, L. Tomlinson, C. Galletly, N. D. Luscombe, and R. J. Norman Ghrelin and Measures of Satiety Are Altered in Polycystic Ovary Syndrome But Not Differentially Affected by Diet Composition J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3337 - 3344. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Norman, M. Noakes, R. Wu, M. J. Davies, L. Moran, and J. X. Wang Improving reproductive performance in overweight/obese women with effective weight management Hum. Reprod. Update, May 1, 2004; 10(3): 267 - 280. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Salmi, H. C. Zisser, and L. Jovanovic Screening for and Treatment of Polycystic Ovary Syndrome in Teenagers Experimental Biology and Medicine, May 1, 2004; 229(5): 369 - 377. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Managing anovulatory infertility DTB, April 1, 2004; 42(4): 28 - 32. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. W. C. M. van Dam, F. Roelfsema, J. D. Veldhuis, S. Hogendoorn, J. Westenberg, F. M. Helmerhorst, M. Frolich, H. M. J. Krans, A. E. Meinders, and H. Pijl Retention of estradiol negative feedback relationship to LH predicts ovulation in response to caloric restriction and weight loss in obese patients with polycystic ovary syndrome Am J Physiol Endocrinol Metab, April 1, 2004; 286(4): E615 - E620. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Rotterdam ESHRE/ASRM-sponsored PCOS consensus Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS) Hum. Reprod., January 1, 2004; 19(1): 41 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. G. Crosignani, M. Colombo, W. Vegetti, E. Somigliana, A. Gessati, and G. Ragni Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet Hum. Reprod., September 1, 2003; 18(9): 1928 - 1932. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. M Ahmed Polycystic ovaries: the role of insulin Perspectives in Public Health, June 1, 2003; 123(2): 78 - 79. [PDF]
|
|
|
|
|
|
L. J. Moran, M. Noakes, P. M. Clifton, L. Tomlinson, and R. J. Norman Dietary Composition in Restoring Reproductive and Metabolic Physiology in Overweight Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., February 1, 2003; 88(2): 812 - 819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. George, K. George, C. Irwin, V. Job, R. Selvakumar, V. Jeyaseelan, and M.S. Seshadri Sequential treatment of metformin and clomiphene citrate in clomiphene-resistant women with polycystic ovary syndrome: a randomized, controlled trial Hum. Reprod., February 1, 2003; 18(2): 299 - 304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Homburg What is polycystic ovarian syndrome?: A proposal for a consensus on the definition and diagnosis of polycystic ovarian syndrome Hum. Reprod., October 1, 2002; 17(10): 2495 - 2499. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Balen and K. Michelmore What is polycystic ovary syndrome?: Are national views important? Hum. Reprod., September 1, 2002; 17(9): 2219 - 2227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Loh, J. X. Wang, and C. D. Matthews The influence of body mass index, basal FSH and age on the response to gonadotrophin stimulation in non-polycystic ovarian syndrome patients Hum. Reprod., May 1, 2002; 17(5): 1207 - 1211. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Homburg Should patients with polycystic ovarian syndrome be treated with metformin?: A note of cautious optimism Hum. Reprod., April 1, 2002; 17(4): 853 - 856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Tackling polycystic ovary syndrome DTB, January 1, 2001; 39(1): 1 - 5. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. I Barr Vegetarianism and menstrual cycle disturbances: is there an association? Am. J. Clinical Nutrition, September 1, 1999; 70(3): 549S - 554. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Bützow, J. M. Moilanen, M. Lehtovirta, T. Tuomi, O. Hovatta, R. Siegberg, C.-G. Nilsson, and D. Apter Serum and Follicular Fluid Leptin during in Vitro Fertilization: Relationship among Leptin Increase, Body Fat Mass, and Reduced Ovarian Response J. Clin. Endocrinol. Metab., September 1, 1999; 84(9): 3135 - 3139. [Abstract] [Full Text]
|
|
|
|
 |
|
 L. Poretsky, N. A. Cataldo, Z. Rosenwaks, and L. C. Giudice The Insulin-Related Ovarian Regulatory System in Health and Disease Endocr. Rev., August 1, 1999; 20(4): 535 - 582. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-M. Huber-Buchholz, D. G. P. Carey, and R. J. Norman Restoration of Reproductive Potential by Lifestyle Modification in Obese Polycystic Ovary Syndrome: Role of Insulin Sensitivity and Luteinizing Hormone J. Clin. Endocrinol. Metab., April 1, 1999; 84(4): 1470 - 1474. [Abstract] [Full Text]
|
|
|
|
|
|
H. Lashen, W. Ledger, A. L. Bernal, and D. Barlow Extremes of body mass do not adversely affect the outcome of superovulation and in-vitro fertilization Hum. Reprod., March 1, 1999; 14(3): 712 - 715. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Karlsson, K. Lindell, E. Svensson, C. Bergh, P. Lind, H. Billig, L. M. S. Carlsson, and B. Carlsson Expression of Functional Leptin Receptors in the Human Ovary J. Clin. Endocrinol. Metab., December 1, 1997; 82(12): 4144 - 4148. [Abstract] [Full Text] [PDF]
|
|