Abstract
A lifestyle intervention should be recommended to all women with polycystic ovary syndrome (PCOS) who are overweight or obese. Available data support the concept that a significant improvement in achieving higher ovulation and fertility rates is possible with such intervention. It is expected that in normal weight PCOS women a healthy diet can positively influence fertility processes. The amount of weight loss is a critical component in the possibility of becoming pregnant. Although no studies are available on this aspect, personalized treatment including lifestyle interventional programs based on the type of therapeutic procedure planned to favour a pregnancy according to the woman’s needs, particularly on how to treat infertility, is desirable.
References
McCartney CR, Marshall JC. Clinical practice. Polycystic ovary syndrome. N Engl J Med. 2016;375:54–64.
Conway G, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Franks S, Gambineri A, Kelestimur F, Macut D, Micic D, Pasquali R, Pfeifer M, Pignatelli D, Pugeat M, Yildiz BO, ESE PCOS Special Interest Group. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 2014;171:P1–29.
Pasquali R, Diamanti-Kandarakis E, Gambineri A. Management of endocrine disease: secondary polycystic ovary syndrome: theoretical and practical aspects. Eur J Endocrinol. 2016;175:R157–69.
Pasquali R, Gambineri A. A comprehensive approach in diagnosing the polycystic ovary syndrome. Womens Health (Lond). 2015;11:501–12.
Rosenfield RL. Clinical review: adolescent anovulation: maturational mechanisms and implications. J Clin Endocrinol Metab. 2013;98:3572–83.
The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod. 2008;23:462–77.
Balen AH, Anderson R. Impact of obesity on female reproductive health: British fertility society, police and practice guidelines. Hum Fertil (Camb). 2007;10:195–206.
Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK, Society E. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98:4565–92.
Barry J, Kuczmierczyk A, Hardiman P. Anxiety and depression in PCOS: a systematic review and meta-analysis. Hum Reprod. 2011;26:2442–51.
Tan S, Hahn S, Benson S, Janssen O, Dietz T, Kimmig R, Hesse-Huissain J, Mann K, Schedlowsky M, Arck P. Psychological implications of infertility in women with PCOS. Hum Reprod. 2008;23:2064–71.
Kerchner A, Lester W, Stuart SP, Dokras A. Risk of depression and other mental health disorders in women with polycystic ovary syndrome: a longitudinal study. Fertil Steril. 2009;91:207–12.
Hahn S, Janssen OE, Tan S, Pleger K, Mann K, Schedlowski M, Kimmig R, Benson S, Balamitsa E, Elsenbruch S. Clinical and psychological correlates of quality-of-life in polycystic ovary syndrome. Eur J Endocrinol. 2005;153:853–60.
Misso M, Boyle J, Norman R, Teede H. Development of evidenced-based guidelines for PCOS and implications for community health. Semin Reprod Med. 2014;32:230–40.
Pasquali R. The hypothalamic-pituitary-adrenal axis and sex hormones in chronic stress and obesity: pathophysiological and clinical aspects. Ann N Y Acad Sci. 2012;1264:20–35.
Elsenbruch S, Benson S, Hahn S, Tan S, Mann K, Pleger K, Kimmig R, Jansen O. Determinants of emotional distress in women with PCOS. Hum Reprod. 2006;21:1092–9.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. A prospective study of dairy foods intake and anovulatory infertility. Hum Reprod. 2007;22:1340–7.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. A prospective study of dietary carbohydrate quantity and quality in relation to risk of ovulatory infertility. Eur J Clin Nutr. 2009;63:78–86.
Altieri P, Cavazza C, Pasqui F, Morselli AM, Gambineri A, Pasquali R. Dietary habits and their relationship with hormones and metabolism in overweight and obese women with polycystic ovary syndrome. Clin Endocrinol. 2013;78:52–9.
Douglas CC, Norris LE, Oster RA, Darnell BE, Azziz R, Gower BA. Difference in dietary intake between women with polycystic ovary syndrome and healthy controls. Fertil Steril. 2006;86:411–7.
Merhi Z. Advanced glycation end products and their relevance in female reproduction. Hum Reprod. 2014;29:135–45.
Garg D, Merhi Z. Advanced glycation end products: link between diet and ovulatory dysfunction in PCOS? Forum Nutr. 2015;7:10129–44.
Piperi C, Adamopoulos C, Dalagiorgou G, Diamanti-Kandarakis E, Papavassiliou AG. Crosstalk between advanced glycation and endoplasmic reticulum stress: emerging therapeutic targeting for metabolic diseases. J Clin Endocrinol Metab. 2012;97:2231–42.
Papalou O, Victor VM, Diamanti-Kandarakis E. Oxidative stress in polycystic ovary syndrome. Curr Pharm Des. 2016;22:2709–22.
Tarabusi V, Cavazza C, Pasqui F, Gambineri A, Pasquali R. Quality of diet, screened by the Mediterranean diet quality index and the evaluation of the content of advanced glycation end products, in a population of high school students from Emilia Romagna. Mediterr J Nutr Metab. 2010;3:153–7.
Diamanti-Kandarakis E, Katsikis I, Piperi C, Kandaraki E, Piouka A, Papavassiliou AG, Panidis D. Increased serum advanced glycation end-products is a distinct finding in lean women with polycystic ovary syndrome (PCOS). Clin Endocrinol. 2008;69:634–41.
Tantalaki E, Piperi C, Livadas S, Kollias A, Adamopoulos C, Koulouri A, Christakou C, Diamanti-Kandarakis E. Impact of dietary modification of advanced glycation end products (AGEs) on the hormonal and metabolic profile of women with polycystic ovary syndrome (PCOS). Hormones (Athens). 2014;13:65–73.
Vujkovic M, de Vries JH, Lindemans J, Macklon NS, van der Spek PJ, Steegers EA, Steegers-Theunissen RP. The preconception Mediterranean dietary pattern in couples undergoing in vitro fertilization/intracytoplasmic sperm injection treatment increases the chance of pregnancy. Fertil Steril. 2010;94:2096–101.
Lerchbaum E, Rabe T. Vitamin D and female fertility. Curr Opin Obstet Gynecol. 2014;26:145–50.
Dabrowski FA, Grzechocinska B, Wielgos M. The role of vitamin D in reproductive health–a Trojan horse or the golden fleece? Forum Nutr. 2015;7:4139–53.
Pasquali R, Stener-Victorin E, Yildiz BO, Duleba AJ, Hoeger K, Mason H, Homburg R, Hickey T, Franks S, Tapanainen JS, Balen A, Abbott DH, Diamanti-Kandarakis E, Legro RS. PCOS Forum: research in polycystic ovary syndrome today and tomorrow. Clin Endocrinol. 2011;74:424–33.
Shaum KM, Polotsky AJ. Nutrition and reproduction: is there evidence to support a “fertility diet” to improve mitochondrial function? Maturitas. 2013;74:309–12.
Chavarro JE. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007;110:1050–8.
Chang AS, Dale AN, Moley KH. Maternal diabetes adversely affects preovulatory oocyte maturation, development, and granulosa cell apoptosis. Endocrinology. 2005;146:2445–53.
Wittemer C, Ohl J, Bailly M, Bettahar-Lebugle K, Nisand I. Does body mass index of infertile women have an impact on IVF procedure and outcome? J Assist Reprod Genet. 2000;17:547–52.
Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment of obesity in polycystic ovary syndrome: a position statement of the androgen excess and polycystic ovary syndrome society. Fertil Steril. 2009;92:1966–82.
Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;7:CD007506.
Crosignani PG, Colombo M, Vegetti W, Somigliana E, Gessati A, Ragni G. Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices ovarian physiology and fertility rate induced by diet. Hum Reprod. 2003;18:1928–32.
Mutsaerts MAQ, van Oers AM, Groen H, Burggraaff JM, Kuchenbecker WK, Perquin DA, Koks CA, van Golde R, Kaaijk EM, Schierbeek JM, Oosterhuis GJ, Broekmans FJ, Bemelmans WJ, Lambalk CB, Verberg MF, van der Veen F, Klijn NF, Mercelina PE, van Kasteren YM, Nap AW, Brinkhuis EA, Vogel NE, Mulder RJ, Gondrie ET, de Bruin JP, Sikkema JM, de Greef MH, ter Bogt NC, Land JA, Mol BW, Hoek A. Randomized trial of a lifestyle program in obese infertile women. N Engl J Med. 2016;374:1942–53.
Domecq JP, Prutsky G, Mullan RJ, Hazem A, Sundaresh V, Elamin MB, Phung OJ, Wang A, Hoeger K, Pasquali R, Erwin P, Bodde A, Montori VM, Murad MH. Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis. J Clin Endocrinol Metab. 2013;98:4655–63.
Pasquali R, Gambineri A, Cavazza C, Ibarra Gasparini D, Ciampaglia W, Cognigni GE, Pagotto U. Heterogeneity in the responsiveness to long-term lifestyle intervention and predictability in obese women with polycystic ovary syndrome. Eur J Endocrinol. 2011;164:53–60.
Skubleny D, Switzer NJ, Gill RS, Dykstra M, Shi X, Sagle MA, de Gara C, Birch DW, Karmali S. The impact of bariatric surgery on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Surg. 2016;26:169–76.
Butte NF, King JC. Energy requirements during pregnancy and lactation. Public Health Nutr. 2005;8:1010–27.
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Pasquali, R. (2018). Lifestyle Interventions and Natural and Assisted Reproduction in Patients with PCOS. In: Palomba, S. (eds) Infertility in Women with Polycystic Ovary Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-45534-1_13
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DOI: https://doi.org/10.1007/978-3-319-45534-1_13
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