scholarly journals The Impact of COVID-19 Lockdown on Weight Loss Program in Infertile Polycystic Ovary Syndrome Women with Obesity

Obesity Facts ◽  
2021 ◽  
pp. 1-8
Author(s):  
Ana Šuštaršič ◽  
Eda Vrtačnik Bokal ◽  
Tanja Burnik Papler

<b><i>Introduction:</i></b> Lockdown due to the COVID-19 pandemic has caused gym closures and adjustments to ongoing weight loss programs were needed in order to keep the programs running. Little is known whether adjustments affected the success of weight reduction. Weight reduction of at least 5% is related to improved fertility and better pregnancy outcomes in obese women. This study compared success of the weight loss program in infertile polycystic ovary syndrome women with obesity who attended the program before and during lockdown due to COVID-19 pandemic. Furthermore, we checked whether there were any differences in spontaneous pregnancy rates between both groups at the end of the program. <b><i>Methods:</i></b> Altogether, 27 women were prospectively included to the weight loss program. Twelve women attended the 8 – week program before COVID-19 pandemic. Fifteen women began the program before the lockdown and ended it during lockdown. Due to lockdown, the program was prolonged for 4 weeks and taken online. <b><i>Results:</i></b> On average, prior to lockdown women achieved a BMI reduction of 6.8% whereas women that attended the program during the lockdown reduced their BMI for 3.7%. This difference was not statistically significant. No significant differences were seen in other measured anthropometric and endocrine parameters between both groups. Furthermore, there were no differences in spontaneous pregnancy rates between both groups. In women who reduced their BMI for 5% or more, spontaneous pregnancy rate was 29.4%. <b><i>Discussion/Conclusions:</i></b> Although statistical significance has not been reached in the present study, we have shown that lockdown due to COVID-19 pandemic has led to almost half lower BMI reduction despite adaptations and longer duration of the weight loss program. On average, BMI in the group of women that attended the program during lockdown was 3.7% lower after the end of the weight loss program. This means they did not reach the wanted 5% reduction which is known to improve fertility. We have also shown that weight reduction is the correct approach for treating infertile women with obesity, as almost 30% of those who reduced their body weight by 5% or more conceived spontaneously.

Author(s):  
Sevinç Ünal ◽  
Memet Şimşek

INTRODUCTION: Most of the obese PCOS patients are resistant to clomiphene citrate standard doses. In these cases metabolic syndromes are treated by using insulin sensitizing drugs so that ovulation can be achieved.In this study rosiglitazine maleat was used in order to induce ovulation in obese clomiphene resistant PCOS patients. METHODS: 30 women(18-40 year old) with clomiphene resistant polycystic ovary syndrome that were obese (BMI>25 kg/m2) and hyperinsulinemic were seperated in two groups. In the first group (n=15) oral antidiabetic Rosiglitazone maleate( 4mg bid) which belongs to thiazolidinediones were used.In the second group(n=15) in addition to clomiphen citrate(50 bid)and Rosiglitazone maleate(4 mg bid) were used, ovulation and pregnancy rates were compared. In both groups ovulation and pregnancy were recorded, in the second group ovulation and pregnancy rates were higher than the first group but these rates were not significant. RESULTS: In group 1, ovulation was achieved in 5 patients (%33) and pregnancy was achieved in 1 patient (%7). In group 2, ovulation was achieved in 9 patients (%60) and pregnancy was achieved in 3 patients (%20).There was no statistical significance between two groups. DISCUSSION AND CONCLUSION: In our study in obese and hyperinsulinemic patients rosiglitazone maleat can induce ovulation and in addition to clomiphene citrate also ovulation can be achieved although it is statistical insignificant. As a result Rosiglitazone maleate can be used alternatively as an insulin sensitizer and ovulation induction agent.


2016 ◽  
Vol 68 (3) ◽  
pp. 220-227 ◽  
Author(s):  
Nayara Pereira Soares ◽  
Ana Celly Souza dos Santos ◽  
Eduardo Caldas Costa ◽  
George Dantas Azevedo ◽  
Débora Cristina Damasceno ◽  
...  

Aims: We aimed to investigate the impact of following a diet to induce weight loss (500 kcal deficit per day) over DNA damage and cardiometabolic risk factors in women with overweight/obesity diagnosed with polycystic ovary syndrome (PCOS). Methods: A study was conducted in Natal, RN, Brazil selecting overweight/obese (body mass index ≥25 and <39 kg/m2) women (18-35 years). The levels of DNA damage were assessed by a single cell gel electrophoresis. Repeated 24 h dietary recall questionnaires, anthropometry, biochemical profile and sex hormones were collected at baseline and after 12 weeks of intervention. Results: Women exhibiting a decrease in the markers of DNA damage: tail intensity (24.35 ± 5.86 - pre diet vs. 17.15 ± 5.04 - post-diet; p < 0.001) and tail moment (20.47 ± 7.85 - pre diet vs. 14.13 ± 6.29 - post-diet; p < 0.002). Reduction of calorie intake, weight loss, decreased sexual hormone and cardiometabolic markers such as insulin, homeostasis model assessment of insulin resistance and low-density lipoprotein cholesterol were verified In the multivariate regression analysis, quantitative insulin sensitivity check index and progesterone were responsible for the variation markers in DNA damage before the diet, losing its influence upon diet. Conclusion: DNA damage and the impact of cardiometabolic risk factors decreased after the intervention in women with PCOS, indicating the relevance of a nutritional approach in this group of patients.


Author(s):  
Nearmeen M. Rashad ◽  
Yasser S. Saraya ◽  
Samir A. Afifi ◽  
Ayman E. Ali ◽  
Radwa M. Al-sayed

Abstract Background Polycystic ovary syndrome (PCOS) is a common reproductive endocrine co-morbidity of obesity. Ghrelin is a peptide which regulates food intake and body weight. The aim of this study was to measure ghrelin levels in obesity and PCOS and to evaluate the impact of weight loss on plasma ghrelin level, metabolic, and phenotypic features of PCOS. This prospective comparative study enrolled obese women without PCOS (N = 60) and obese PCOS women (n = 50) and 85 control groups. Body compositions including fat mass (FM) and fat-free mass (FFM) were measured by dual-energy X-ray absorptiometry (DEXA). Plasma ghrelin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Results Our results revealed that plasma ghrelin levels were lower in PCOS patients compared to obese (9.49 ± 5.59 ng/ml) and controls (48.21 ± 21.09 ng/ml). Moreover, it was negatively correlated to anthropometric measures, glycemic, lipid profile, and the phenotype characteristics of PCOS. Interestingly, after 12 weeks of following the Mediterranean diet (MD)-based weight loss program, ghrelin levels were increased in both obese groups. Conclusion Successful weight loss leads to increase ghrelin levels in both obese and PCOS groups.


2018 ◽  
Vol 35 (2) ◽  
pp. 119-123 ◽  
Author(s):  
Ashraf Moini ◽  
Arezoo Arabipoor ◽  
Mandana Hemat ◽  
Jila Ahmadi ◽  
Reza Salman-Yazdi ◽  
...  

2011 ◽  
Vol 164 (1) ◽  
pp. 53-60 ◽  
Author(s):  
Renato Pasquali ◽  
Alessandra Gambineri ◽  
Carla Cavazza ◽  
Daniela Ibarra Gasparini ◽  
Walter Ciampaglia ◽  
...  

BackgroundTreatment of obesity improves all features of the polycystic ovary syndrome (PCOS). There is, however, a heterogeneous response to weight loss, and predictive factors are unknown.ObjectiveThis follow-up study aimed to investigate obese women with PCOS treated with a long-term lifestyle program to evaluate responsiveness and predictability.MethodsOne hundred PCOS women meeting the criteria for selection were invited to participate and 65 of them agreed. Lifestyle intervention had consisted of a 1200–1400 kcal/day diet for 6 months, followed by mild calorie restriction and physical activity. The protocol, which was similar at baseline and follow-up, included anthropometry, clinical evaluation, pelvic ultrasound, and laboratory investigations. The mean follow-up period was 20.4±12.5 months.ResultsAfter the follow-up period, women were reclassified into three groups according to the persistence (group 1, 15.4%), partial (group 2, 47.7%), or complete (group 3, 36.9%) disappearance of the categorical features of PCOS (hyperandrogenism, menses, and ovulatory dysfunctions). Duration of the follow-up and extent of weight loss were similar among the three groups, as were fasting and glucose-stimulated insulin and indices of insulin resistance. Baseline waist circumference, waist to hip ratio (WHR), and androstenedione blood levels were negatively correlated with a better outcome in the univariate analysis. However, only basal androstenedione values persisted to a highly significant extent (P<0.001) in the multivariate analysis.ConclusionsResponsiveness to weight loss in overweight/obese PCOS women varies considerably and more than one third of women may achieve full recovery. These findings add new perspectives to the impact of obesity on the pathophysiology of PCOS.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1612-P
Author(s):  
NADIRA SULTANA KAKOLY ◽  
ARUL EARNEST ◽  
HELENA TEEDE ◽  
LISA MORAN ◽  
DEBORAH LOXTON ◽  
...  

2014 ◽  
pp. 86-93
Author(s):  
Minh Tam Le

Backgrounds: Polycystic Ovary Syndrome (PCOS) is one of the most common causes of female infertility due to ovulation disorders. Clomiphene citrate (CC) is a first choice to restore ovulation but it has some side effects by estrogen receptor down-regulation. Aromatase inhibitor (AI) is a newer class of drugs which increases the production of endogenous FSH to stimulate ovulation. Subjects and methods: randomized control trial to compare 64 cases of infertile women with PCOS examined at the Hue University Hospital, alternately used AI (group I) or CC (group II) for ovulation induction from day 2 cycle. Follow-up follicle growth, endometrium and ovulation via ultrasound. Evaluation were done on 10th day cycle, day of hCG trigger and after administration of hCG. Results: Total of 64 PCOS cases distributed into 2 groups using alternatively AI and CC had similar characteristics with average age of 28.8 ± 4.6, the majority were primary infertility (84.4%), infertility duration was 2.6 ± 2.4 years, 85.9% had oligomenorrhrea or amenorrhea, normal body mass index accounts for 60.9% and 21.9% was lean. Evaluation of both groups on day 10 revealed no differences in the dominant follicle and endometrial thickness. Number of days until the follicle mature appears to be shorter in AI group (15.1 ± 2.9) compared to the CC group (16.5 ± 2.8) with statistical significance. The number of mature follicles in 2 groups were not different at a rate of 81.3% (AI) and 84.4% (CC) but a higher proportion of single mature follicle in the AI ​​group (71.9%) compared with the CC group (65.7%) and There is no case with 3-4 mature follicles in the AI group. The rate of thin endometrium (<8 mm) in the AI group (25%) was lower than the CC group (53.1%) with statistically significance and higher ovulation rate (68.8%) compared with the CC group (56.3%) but have not found statistically significant. Conclusion: Two drugs AI and CC potentially induce follicle development and ovulation similarly, but AI has the potential to be more effective than CC on factors such as the shorter stimulation duration, increasing rate of single follicle, limiting multiple pregnancies, improve endometrial thickness and higher ovulation rate. More researches are needed with a larger sample size to clarify the statistical significance of differences.


2019 ◽  
Vol 17 (5) ◽  
pp. 455-464 ◽  
Author(s):  
Alfonso Mate ◽  
Antonio J. Blanca ◽  
Rocío Salsoso ◽  
Fernando Toledo ◽  
Pablo Stiefel ◽  
...  

Pregnancy hypertensive disorders such as Preeclampsia (PE) are strongly correlated with insulin resistance, a condition in which the metabolic handling of D-glucose is deficient. In addition, the impact of preeclampsia is enhanced by other insulin-resistant disorders, including polycystic ovary syndrome and obesity. For this reason, there is a clear association between maternal insulin resistance, polycystic ovary syndrome, obesity and the development of PE. However, whether PE is a consequence or the cause of these disorders is still unclear. Insulin therapy is usually recommended to pregnant women with diabetes mellitus when dietary and lifestyle measures have failed. The advantage of insulin therapy for Gestational Diabetes Mellitus (GDM) patients with hypertension is still controversial; surprisingly, there are no studies in which insulin therapy has been used in patients with hypertension in pregnancy without or with an established GDM. This review is focused on the use of insulin therapy in hypertensive disorders in the pregnancy and its effect on offspring and mother later in life. PubMed and relevant medical databases have been screened for literature covering research in the field especially in the last 5-10 years.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sairish Ashraf ◽  
Shayaq Ul Abeer Rasool ◽  
Mudasar Nabi ◽  
Mohd Ashraf Ganie ◽  
Shariq R. Masoodi ◽  
...  

AbstractPolycystic ovary syndrome (PCOS) is the most common reproductive endocrine disorder in pre-menopausal women having complex pathophysiology. Several candidate genes have been shown to have association with PCOS. CYP19 gene encodes a key steroidogenic enzyme involved in conversion of androgens into estrogens. Previous studies have reported contradictory results with regard to association of SNP rs2414096 in CYP19 gene with PCOS and hyperandrogenism in different ethnic populations. Present study was aimed to investigate the impact of SNP rs2414096 polymorphism of CYP19 gene on susceptibility of PCOS and hyperandrogenism in Kashmiri women. Further we also studied the genotypic-phenotypic association for various clinical and biochemical parameters of this polymorphism. Case control study. 394 PCOS cases diagnosed on the basis of Rotterdam criteria and age matched 306 healthy women. We found a significant differences in genotypic frequency (χ2 = 18.91, p < 0.05) as well as allele frequency (OR 0.63, CI 0.51–0.78, χ2 = 17.66, p < 0.05) between PCOS women and controls. The genotype–phenotype correlation analysis showed a significant difference in FG score (p = 0.047) and alopecia (p = 0.045) between the three genotypes. Also, the androgen excess markers like DHEAS (p < 0.001), Androstenedione (p < 0.001), Testosterone (p < 0.001) and FAI (p = 0.005) were significantly elevated in GG genotype and showed a significant difference in additive model in PCOS women. rs2414096 polymorphism of CYP19 gene is associated with the risk of PCOS as well as with clinical and biochemical markers of hyperandrogenism, hence suggesting its role in clinical manifestations of PCOS in Kashmiri women.


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