Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of reproductive age, with a prevalence of 6–18%. The causes are complex & poorly understood. It can be due to genetic, environmental, or epigenetic changes. These females usually have high levels of androgens (male hormone) in their bodies which alters the hormonal milieu causing anovulation & insulin resistance leading to deranged blood sugars. These hormonal abnormalities contribute to clinical features, including excessive hair growth or acne, oily skin, pigmentation of the neck, oligo-/anovulation and polycystic ovarian morphology on ultrasound, type 2 diabetes (DM2), metabolic syndrome, and cardiovascular disease. Women with PCOS appear to have a higher weight gain and a higher prevalence of overweight, obesity, and central obesity compared to women without PCOS. There is also a higher risk of psychological complications, including depression and anxiety. A vicious cycle of hyperandrogenemia, insulin resistance, and anovulation is seen in them. The altered hormonal profile can affect the oocyte quality & endometrial receptivity in certain females, becoming a cause of infertility in a few where ovulation is achieved.
In women genetically predisposed to PCOS development, obesity can result in its clinical & biochemical manifestation. Obesity, especially central obesity, worsens the presentation of the syndrome. Visceral fat releases a higher amount of fatty acids, adipokines & leptin in the blood. All these worsen the insulin resistance, hence exacerbating the hyperandrogenemia & anovulation, hence negatively affect fertility.
Weight loss, in turn, improves all the features of PCOS, making lifestyle modifications (diet, physical activity, and behavior) changes and weight management the first-line recommendation in PCOS management.
- Weight loss of 5-10% in 6 months is considered a good weight loss.
- Energy deficit of 30% or 500-750 kcal/day after individual consideration.
- 75 minutes/week of vigorous physical activity or 150 min/week of moderate level activity.
- Drugs for weight loss are to be considered only with the physician’s approval.
- Bariatric surgery can be considered for morbidly obese patients.
PCOS is a challenge in the medical fraternity. A holistic approach to weight loss is very important. Every woman with PCOS and metabolic abnormalities should be given appropriate counseling regarding the role of weight loss in alleviating their burden of PCOS disease.
Seeds of Innocence is a leading chain of fertility clinics with several branches across India. Armed with a team of experienced and highly qualified IVF specialists, we are a one-stop solution to all your woes and concerns regarding infertility.