Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study
Abstract
BACKGROUND: Lifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome (PCOS). The aims of the current pilot study were (i) to compare the efficacy on reproductive functions of a structured exercise training (SET) programme with a diet programme in obese PCOS patients and (ii) to study their clinical, hormonal and metabolic effects to elucidate potentially different mechanisms of action. METHODS: Forty obese PCOS patients with anovulatory infertility underwent a SET programme (SET group, n = 20) and a hypocaloric hyperproteic diet (diet group, n = 20). Clinical, hormonal and metabolic data were assessed at baseline, and at 12- and 24-week follow-ups. Primary endpoint was cumulative pregnancy rate. RESULTS: The two groups had similar demographic, anthropometric and biochemical parameters. After intervention, a significant improvement in menstrual cycles and fertility was noted in both groups, with no differences between groups. The frequency of menses and the ovulation rate were significantly (P < 0.05) higher in the SET group than in diet group but the increased cumulative pregnancy rate was not significant. Body weight, body mass index, waist circumference, insulin resistance indexes and serum levels of sex hormone-binding globulin, androstenedione and dehydroepiandrosterone sulphate changed significantly (P < 0.05) from baseline and were significantly different (P < 0.05) between the two groups. CONCLUSIONS: Both SET and diet interventions improve fertility in obese PCOS patients with anovulatory infertility. We hypothesize that in both interventions an improvement in insulin sensitivity is the pivotal factor involved in the restoration of ovarian function but potentially acting through different mechanisms.
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In one study, participants self-selected into their intervention group, which may have introduced selection bias.
“participants self-selected into their intervention group, which may have introduced selection bias into the study”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [103]
Participants who resumed ovulation had decreased body weight and abdominal fat.
“Participants who resumed ovulation had decreased body weight [100,103] and abdominal fat [100]”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [103]
Some studies had participants self-select the intervention group, introducing selection bias and affecting internal validity.
“other studies had participants self-select the intervention group [103], introducing selection bias and affecting internal validity”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [103]
The combination of dietary changes with exercise appears to confer an additional cardiometabolic benefit than just one component alone, and at times even in the absence of changes in weight or anthropometric measures.
“the combination of dietary changes with exercise appears to confer an additional cardiometabolic benefit than just one component alone [101,102,103,109], and at times, even in the absence of changes in weight or anthropometric measures [103,109]”
From Moving beyond Weight: A Narrative Review of the Dietary and Lifestyle Management for Reducing Cardiometabolic Risk in Polycystic Ovary Syndrome (PCOS) (2023) · cites this paper as [103]
One low-quality non-RCT (level III-2) with a high risk of bias compared exercise to low-caloric, high-protein diet in PCOS.
“One lowquality non-RCT (level III-2) with a high risk of bias compared exercise to low-caloric, high-protein diet in PCOS. 164”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
SET was better than diet for ovulation rate (P=0.03).
“and ovulation rate ( P = 0.03).”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
Structured exercise training (SET) was better than diet for menses frequency (P=0.04).
“Structured exercise training (SET) was better than diet for menses frequency ( P =0.04)”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
Exercise increased ovulation rate (P=0.03).
“increased ovulation rate ( P =0.03);”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
One study found that exercise was better for menses frequency (P=0.04).
“One study found that exercise was better for menses frequency ( P =0.04);”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
Exercise increased cumulative ovulation rate (P=0.01).
“and increased cumulative ovulation rate ( P =0.01). 164”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [164]
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- Authors
- Palomba, S., Giallauria, F., Falbo, A., Russo, T., Oppedisano, R., Tolino, A., Colao, A., Vigorito, C., Zullo, F., & Orio, F.
- Affiliations
- Magna Graecia University (IT)
- Federico II University Hospital (IT)
- Parthenope University of Naples (IT)
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-03-01
- Volume
- 23
- Issue
- 3
- Pages
- 642-650
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2147677732
- Cited by
- 235
- References
- 52
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 14 · 2020: 12 · 2019: 18 · 2018: 14 · 2017: 13 · 2016: 12 · 2015: 12 · 2014: 15 · 2013: 14 · 2012: 12
- FWCI
- 12.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- polycystic ovary syndrome, obesity, anovulatory infertility, exercise training, lifestyle modification, cumulative pregnancy rate, ovulation rate, menstrual cycle, insulin resistance, sex hormone-binding globulin, androstenedione, dehydroepiandrosterone sulfate, ovarian function
- MeSH terms
- Adult, Anovulation, Female, Humans, Insulin, Life Style, Pilot Projects, Polycystic Ovary Syndrome, Pregnancy, Reproduction, Cohort Studies, Exercise, Pregnancy Rate
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