ASRM 2019 — PCOS: weight loss improves fertility


  • Daniel M. Keller, Ph.D
  • Conference Reports
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Takeaway

  • Lifestyle intervention targeting obese women with infertility improved conception chances, even without fertility treatment, especially for women with PCOS.

Why this matters

  • Lifestyle interventions that improve the chance of conceiving for women with obesity and infertility could lower costs of fertility treatments, possibly improving effectiveness of assisted reproductive technologies.

Study design

  • Randomized controlled trial: women 18-40 years old, infertility, and obesity (BMI30 kg/m 2 ) or PCOS and overweight (BMI≥27 kg/m 2 ).
    • Standard of care control group (CG) or lifestyle program group (LPG) with kinesiologist, nutritionist, and group sessions.
  • 108 women completed ≥6 months of study: 51 LPG (PCOS, n=33; non-PCOS, n=18); 57 CG (PCOS, n=35; non-PCOS, n=22).
  • Ferring Inc: unrestricted grant for Fit-for-Fertility trial.

Key results

  • LPG women lost more weight at 6 months vs CG.
    • All: −3.19%±4.45% vs −0.77%±3.67% (P=.003), and
    • PCOS: −3.66%±4.47% vs −0.93%±4.22% (P=.015).
  • At 18 months LPG increased pregnancy rate (60.8%) vs CG (38.6%) (P=.021).
    • PCOS women: 57.6% vs 34.3% (P=.05).
  • Lifestyle program increased spontaneous pregnancy rates vs CG
    • Whole group: 33.3% vs 12.3% (P=.009), and
    • PCOS: 27.3% vs 5.7% (P=.016).
  • Lifestyle program increased live births for women with PCOS: 54.8% vs CG 31.4% (P=.05).
  • Pregnancy rates for women using assisted reproductive technology (ART) trended nonsignificantly higher for all women in LPG.

Limitations

  • Limited power to determine possible effects of lifestyle changes on fertility of women without PCOS.