Exercise And Weight Loss Could Help Fertility In Women With PCOS

While the study was small, the results are compelling.
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Digital Vision. via Getty Images

By Lisa Rapaport

(Reuters Health) - Women who suffer from a leading cause of infertility may increase their odds of conception if they exercise and lose weight, a U.S. study suggests. 

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.

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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10 Fertility Facts You May Not Know
(01 of10)
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1. Your fertility is mostly determined by genetics, which influences how many eggs you are born with. Doctors believe that the number of eggs you have at birth determines the length of time you will remain fertile. At birth, women have about two million eggs in their ovaries. For every egg ovulated during your reproductive life, about 1,000 eggs undergo programmed cell death. Other things, such as smoking cigarettes and certain types of chemotherapy, can accelerate egg cell death and promote an earlier menopause.
(02 of10)
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2. Regular menstrual cycles are a sign of regular ovulation.Most women have regular cycles lasting between 24 and 35 days. This is usually a sign of regular, predictable ovulation. Women who do not ovulate regularly have irregular menstrual cycles. Those who do not ovulate at all may have a genetic condition called polycystic ovarian syndrome (PCOS).
(03 of10)
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3. Basal temperature charting does not predict ovulation.An older method of tracking ovulation involves taking your oral body temperature each morning before getting out of bed. This is called basal body temperature. This method is used to spot a rise in basal temperature, which is a sign that progesterone is being produced. The main problem with using this method is that your temperature rises after ovulation has already occurred. This makes it more difficult to time intercourse at an optimal time for conception. A better method is to use over-the-counter urine ovulation predictor test kits such as Clearblue Easy. These kits test for the hormone that prompts ovulation, which is called luteinizing hormone (LH).
(04 of10)
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4. Most women with blocked fallopian tubes are completely unaware they may have had a prior pelvic infection.About 10 percent of infertility cases are due to tubal disease, either complete blockage or pelvic scarring causing tubal malfunction. One major cause of tubal disease is a prior pelvic infection from a sexually transmitted disease such as chlamydia. These infections can cause so few symptoms that you may be completely unaware your tubes are affected. This is why fertility physicians will order a dye test of the tubes, called a hysterosalpingogram (HSG), if you have been trying and failing to conceive for 6 months or longer.
(05 of10)
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5. In most cases, stress does not cause infertility. Except in rare cases of extreme physical or emotional distress, women will keep ovulating regularly. Conceiving while on vacation is likely less about relaxation than about coincidence and good timing of sex.
(06 of10)
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6. By age 44, most women are infertile, even if they are still ovulating regularly. Even with significant fertility treatment, rates of conception are very low after age 43. Most women who conceive in their mid-40's with fertility treatment are using donated eggs from younger women.
(07 of10)
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7. Having fathered a pregnancy in the past does not guarantee fertility. Sperm counts can change quite a bit with time, so never assume that a prior pregnancy guarantees fertile sperm. Obtaining a semen analysis is the only way to be sure the sperm are still healthy!
(08 of10)
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8. For the most part, diet has little or nothing to do with fertility. Despite popular press, there is little scientific data showing that a particular diet or food promotes fertility. One limited study did suggest a Mediterranean diet with olive oil, fish and legumes may help promote fertility.
(09 of10)
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9. Vitamin D may improve results of fertility treatments. A recent study from the University of Southern California suggested that women who were undergoing fertility treatments, but had low vitamin D levels, might have lower rates of conception. This vitamin is also essential during pregnancy. At Pacific Fertility Center, we recommend our patients take 2,000-4,000 IU per day.
(10 of10)
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10. Being either underweight or overweight is clearly linked with lowered levels of fertility. The evidence in recent years is that obesity is clearly linked with a longer time to conception. Having a body mass index less than 18 or over 32 is associated with problems ovulating and conceiving, as well as problems during pregnancy.

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