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Best Pract Res Clin Obstet Gynaecol. 2015 May;29(4):479-88. doi: 10.1016/j.bpobgyn.2014.11.001. Epub 2014 Nov 12.

Polycystic ovaries and obesity.

Author information

1
Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University of Thessaly, School of Health Sciences, Faculty of Medicine, 41110 Larissa, Greece. Electronic address: messinis@med.uth.gr.
2
Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University of Thessaly, School of Health Sciences, Faculty of Medicine, 41110 Larissa, Greece. Electronic address: messini@med.uth.gr.
3
Embryology, Department of Obstetrics and Gynaecology, University of Thessaly, School of Health Sciences, Faculty of Medicine, 41110 Larissa, Greece. Electronic address: ganif@med.uth.gr.
4
Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University of Thessaly, School of Health Sciences, Faculty of Medicine, 41110 Larissa, Greece. Electronic address: kdafop@med.uth.gr.

Abstract

Almost 50% of the women with polycystic ovary syndrome (PCOS) are obese. Obesity in PCOS affects reproduction via various mechanisms. Hyperandrogenism, increased luteinizing hormone (LH) and insulin resistance play a pivotal role. Several substances produced by the adipose tissue including leptin, adiponectin, resistin and visfatin may play a role in the pathophysiology of PCOS. Infertility in PCOS is related to anovulation. For induction of ovulation, clomiphene citrate and human gonadotrophins are first- and second-line treatments, respectively. Other treatment modalities include the use of insulin sensitizers, such as metformin as well as aromatase inhibitors and laparoscopic ovarian drilling, while in vitro fertilization is the last resort. Obesity can adversely affect infertility treatment in PCOS. Diet and lifestyle changes are recommended for the obese women before they attempt conception. The use of anti-obesity drugs and bariatric surgery in PCOS require further evaluation.

KEYWORDS:

infertility; obesity; ovulation induction; polycystic ovaries; reproduction

PMID:
25487256
DOI:
10.1016/j.bpobgyn.2014.11.001
[Indexed for MEDLINE]

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