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Cited by 61Ovarian function and disordersEndometriosis Research and TreatmentReproductive Health and Technologies

Dietary Modification for Reproductive Health in Women With Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

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Shang, Yujie, Zhou, Huifang, He, Ruohan, Lu, Wentian·2021·Frontiers in Endocrinology
DOI 10.3389/fendo.2021.735954PMC PMC8591222
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Abstract

Objective: Diet has been reported as the first-line management of polycystic ovary syndrome (PCOS). However, the relationship between diet and fertility in PCOS is still controversial. This meta-analysis aimed to evaluate whether diet could promote reproductive health in women with PCOS while providing evidence-based nutrition advice for clinical practice. Methods: Seven databases, including Cochrane Central Register of Controlled Trials, PubMed, Embase, Web of Science, and some Chinese database, were searched up to January 31, 2021. Randomized controlled trials evaluating the effects of diet in women with PCOS were included. Based on a preregistered protocol (PROSPERO CRD42019140454), the systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Two reviewers made study selection, data extraction and bias assessment independently. Risk ratios and mean difference with 95% confidence intervals were assessed by a random-effects model. Statistical heterogeneity within comparisons was evaluated by Cochran’s Q test and quantified by the I-squared ( I 2 ) statistic. Results: Twenty RCTs with 1113 participants were included. Results showed diet significantly related to improved fertility outcomes (increasing clinical pregnancy, ovulation and menstrual regularity rate; reducing miscarriage rate), reproductive endocrine [increasing sex hormone-binding globulin (SHBG); decreasing Anti-Müllerian Hormone (AMH), free androgen index (FAI), total testosterone (T)] and clinical hyperandrogenism (hirsutism assessed by Ferriman-Gallwey score) in PCOS. Specifically, subgroup analyses indicated low-carbohydrate diets were superior in optimizing reproductive outcomes and calorie restriction was critical in ameliorating hyperandrogenism. Additionally, the positive effects were associated with the treatment duration. The longer the duration, the greater the improvement was. Conclusion: Overall, diet is an effective intervention for improving fertility health, thus professional and dynamic dietary advice should be offered to all PCOS patients, based on the changeable circumstances, personal needs and expectations of the individuals.

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  • The same meta-analysis showed that dietary modification increased serum SHBG and reduced total testosterone and free androgen index.

    “This study further showed that dietary modification increased serum SHBG and reduced total testosterone and free androgen index.”

    From Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome (2024) · cites this paper as [38]

  • A meta-analysis of 20 randomized controlled trials comprising a total of 1113 women with PCOS showed that dietary modifications improved pregnancy rate and menstrual regularity with reductions in clinical features of hyperandrogenisms such as hirsutism.

    “A meta-analysis of 20 randomized controlled trials comprising a total of 1113 women with PCOS showed that dietary modifications improved pregnancy rate and menstrual regularity with reductions in clinical features of hyperandrogenisms such as hirsutism [38].”

    From Role of Omega-3 Fatty Acids in Improving Metabolic Dysfunctions in Polycystic Ovary Syndrome (2024) · cites this paper as [38]

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Cited by

Sorted by citations

Authors
Shang, Y., Zhou, H., He, R., & Lu, W.
Affiliations
  • Nanjing University of Chinese Medicine (CN)
  • Hubei Provincial Women and Children's Hospital (CN)
Corresponding author
Zhou, Huifang
ORCID
Venue
Frontiers in Endocrinology
Publisher
Frontiers Media SA
Published
2021-11-01
Volume
12
Pages
735954-735954
ISSN
1664-2392 (ISSN-L)
DOI
10.3389/fendo.2021.735954
PMC
PMC8591222
OpenAlex
W3209683730
Cited by
61
References
16
Citations by year
2026: 15 · 2025: 13 · 2024: 21 · 2023: 7 · 2022: 3 · 2021: 2
FWCI
1.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Endocrinology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (cc-by)
Funders
  • National Natural Science Foundation of China (81973898)
  • Government of Jiangsu Province
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
Keywords
polycystic ovary syndrome, dietary intervention, fertility, low-carbohydrate diet, caloric restriction, hyperandrogenism, menstrual cycle regularity, miscarriage, sex hormone-binding globulin, anti-Müllerian hormone, free androgen index, hirsutism, treatment duration
MeSH terms
Diet, Female, Humans, Polycystic Ovary Syndrome, Databases, Factual, Reproductive Health

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