Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

Erschienen in: Journal für Klinische Endokrinologie und Stoffwechsel 3/2021

12.08.2021 | Originalien

Pregnancy outcome in PCOS patients: The effects of letrozol combined with exercise

verfasst von: Golshan Manteghi, Associate professor Zahra Shahraki, Maryam Nakhaie Moghadam, Assistant professor Mohammad Hosein Ghanbarpour

Erschienen in: Journal für Klinische Endokrinologie und Stoffwechsel | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten
share
TEILEN

Abstract

Introduction

The present study is an attempt to compare the effects of letrozole therapy plus monitored exercise and letrozole therapy alone on pregnancy outcomes in infertile patients with polycystic ovary syndrome (PCOS).

Method

A total of 120 infertile women aged between 18 and 40 years with PCOS participated in this study. The patients were divided to two groups: treatment with letrozole and exercise workouts (Group 1) and treatment with letrozole only (Group 2). All data were analyzed using SPSS 22 software.

Results

The group of women that received exercise had more live births than the group of women that received only letrozole, but this difference was not significant. Biochemical pregnancy rates in Group 1 were significantly lower than Group 2 (p-value < 0.001). The number of follicles and clinical pregnancies was significantly higher in Group 1.

Conclusion

Despite the well-proven benefits of exercise for the general population and the fact that it is recommended as a basis for PCOS management, few completely controlled studies have evaluated the impact of exercise on PCOS. The present study results revealed that regular exercise combined with letrozole therapy would lead to better pregnancy outcomes in women with PCOS compared to letrozole alone.
Literatur
1.
Zurück zum Zitat Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R et al (2012) Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertil Steril 97(1):28–38.e25 CrossRef Fauser BC, Tarlatzis BC, Rebar RW, Legro RS, Balen AH, Lobo R et al (2012) Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-sponsored 3rd PCOS consensus workshop group. Fertil Steril 97(1):28–38.e25 CrossRef
2.
Zurück zum Zitat Melo AS, Ferriani RA, Navarro PA (2015) Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics 70(11):765–769 CrossRef Melo AS, Ferriani RA, Navarro PA (2015) Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics 70(11):765–769 CrossRef
3.
Zurück zum Zitat Sozou PD, Hartshorne GM (2012) Time to pregnancy: a computational method for using the duration of non-conception for predicting conception. Plos One 7(10):e46544 CrossRef Sozou PD, Hartshorne GM (2012) Time to pregnancy: a computational method for using the duration of non-conception for predicting conception. Plos One 7(10):e46544 CrossRef
4.
Zurück zum Zitat Legro RS, Dodson WC, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI et al (2015) Randomized controlled trial of preconceptioninterventions in infertile women with polycystic ovary syndrome. J Clin Endocrinol Metab 100(11):4048–4058 CrossRef Legro RS, Dodson WC, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI et al (2015) Randomized controlled trial of preconceptioninterventions in infertile women with polycystic ovary syndrome. J Clin Endocrinol Metab 100(11):4048–4058 CrossRef
5.
Zurück zum Zitat Domar AD, Seibel MM, Benson H (1990) The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertil Steril 53(2):246–249 CrossRef Domar AD, Seibel MM, Benson H (1990) The mind/body program for infertility: a new behavioral treatment approach for women with infertility. Fertil Steril 53(2):246–249 CrossRef
6.
Zurück zum Zitat Li J, Long L, Liu Y, He W, Li M (2016) Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behav Res Ther 77:96–104 CrossRef Li J, Long L, Liu Y, He W, Li M (2016) Effects of a mindfulness-based intervention on fertility quality of life and pregnancy rates among women subjected to first in vitro fertilization treatment. Behav Res Ther 77:96–104 CrossRef
7.
Zurück zum Zitat Gibson-Helm M, Teede H, Dunaif A, Dokras A (2017) Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 102(2):604–612 PubMed Gibson-Helm M, Teede H, Dunaif A, Dokras A (2017) Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab 102(2):604–612 PubMed
8.
Zurück zum Zitat Dokras A, Saini S, Gibson-Helm M, Schulkin J, Cooney L, Teede H (2017) Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril 107(6):1386e1 CrossRef Dokras A, Saini S, Gibson-Helm M, Schulkin J, Cooney L, Teede H (2017) Gaps in knowledge among physicians regarding diagnostic criteria and management of polycystic ovary syndrome. Fertil Steril 107(6):1386e1 CrossRef
9.
Zurück zum Zitat Kitzinger C, Willmott J (2002) ‘The thief of womanhood’: women’s experience of polycystic ovarian syndrome. Soc Sci Med 54(3):349–361 CrossRef Kitzinger C, Willmott J (2002) ‘The thief of womanhood’: women’s experience of polycystic ovarian syndrome. Soc Sci Med 54(3):349–361 CrossRef
10.
Zurück zum Zitat Veltman-Verhulst SM, Boivin J, Eijkemans MJ, Fauser BJ (2012) Emotional distress is a common risk in women with polycystic ovary syndrome: asystematic review and meta-analysis of 28 studies. Hum Reprod Update 18(6):638–651 CrossRef Veltman-Verhulst SM, Boivin J, Eijkemans MJ, Fauser BJ (2012) Emotional distress is a common risk in women with polycystic ovary syndrome: asystematic review and meta-analysis of 28 studies. Hum Reprod Update 18(6):638–651 CrossRef
11.
Zurück zum Zitat Wild RA, Carmina E, Diamanti-Kandarakis E et al (2010) Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 95(5):2038–2049 CrossRef Wild RA, Carmina E, Diamanti-Kandarakis E et al (2010) Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 95(5):2038–2049 CrossRef
12.
Zurück zum Zitat Palomba S, Giallauria F, Falbo A et al (2008) Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Hum Reprod 23(3):642–650 CrossRef Palomba S, Giallauria F, Falbo A et al (2008) Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study. Hum Reprod 23(3):642–650 CrossRef
13.
Zurück zum Zitat Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ (2009) Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril 92(6):1966–1982 CrossRef Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ (2009) Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril 92(6):1966–1982 CrossRef
14.
Zurück zum Zitat Vigorito C, Giallauria F, Palomba S et al (2007) Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 92(4):1379–1384 CrossRef Vigorito C, Giallauria F, Palomba S et al (2007) Beneficial effects of a three-month structured exercise training program on cardiopulmonary functional capacity in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 92(4):1379–1384 CrossRef
15.
Zurück zum Zitat Sprung VS, Cuthbertson DJ, Pugh CJA et al (2013) Nitric oxide-mediated cutaneous microvascular function is impaired in PCOS but can be improved by exercise training. J Physiol 591(Pt 6):1475–1487 CrossRef Sprung VS, Cuthbertson DJ, Pugh CJA et al (2013) Nitric oxide-mediated cutaneous microvascular function is impaired in PCOS but can be improved by exercise training. J Physiol 591(Pt 6):1475–1487 CrossRef
16.
Zurück zum Zitat Maiorana A, O’Driscoll G, Cheetham C et al (2001) The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes. J Am Coll Cardiol 38(3):860–866 CrossRef Maiorana A, O’Driscoll G, Cheetham C et al (2001) The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes. J Am Coll Cardiol 38(3):860–866 CrossRef
17.
Zurück zum Zitat Walsh JH, Bilsborough W, Maiorana A et al (2003) Exercise training improves conduit vessel function in patients with coronary artery disease. J Appl Physiol 95(1):20–25 CrossRef Walsh JH, Bilsborough W, Maiorana A et al (2003) Exercise training improves conduit vessel function in patients with coronary artery disease. J Appl Physiol 95(1):20–25 CrossRef
18.
Zurück zum Zitat Higashi Y, Sasaki S, Kurisu S et al (1999) Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 100(11):1194–1202 CrossRef Higashi Y, Sasaki S, Kurisu S et al (1999) Regular aerobic exercise augments endothelium-dependent vascular relaxation in normotensive as well as hypertensive subjects: role of endothelium-derived nitric oxide. Circulation 100(11):1194–1202 CrossRef
19.
Zurück zum Zitat Green DJ (2009) Exercise training as vascular medicine: direct impacts on the vasculature in humans. Exerc Sport Sci Rev 37(4):196–202 CrossRef Green DJ (2009) Exercise training as vascular medicine: direct impacts on the vasculature in humans. Exerc Sport Sci Rev 37(4):196–202 CrossRef
20.
Zurück zum Zitat Green DJ, Walsh JH, Maiorana A, Best MJ, Taylor RR, O’Driscoll JG (2003) Exercise-induced improvement in endothelial dysfunction is not mediated by changes in CV risk factors: pooled analysis of diverse patient populations. Am J Physiol Heart Circ Physiol 285(6):H2679–H2687 CrossRef Green DJ, Walsh JH, Maiorana A, Best MJ, Taylor RR, O’Driscoll JG (2003) Exercise-induced improvement in endothelial dysfunction is not mediated by changes in CV risk factors: pooled analysis of diverse patient populations. Am J Physiol Heart Circ Physiol 285(6):H2679–H2687 CrossRef
21.
Zurück zum Zitat Agarwal N, Rice SP, Bolusani H et al (2010) Metformin reduces arterial stiffness and improves endothelial function in young women with polycystic ovary syndrome: a randomized, placebo-controlled, crossover trial. J Clin Endocrinol Metab 95(2):722–730 CrossRef Agarwal N, Rice SP, Bolusani H et al (2010) Metformin reduces arterial stiffness and improves endothelial function in young women with polycystic ovary syndrome: a randomized, placebo-controlled, crossover trial. J Clin Endocrinol Metab 95(2):722–730 CrossRef
22.
Zurück zum Zitat Kyu HH, Bachman VF, Alexander LT et al (2016) Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ 354:i3857 CrossRef Kyu HH, Bachman VF, Alexander LT et al (2016) Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013. BMJ 354:i3857 CrossRef
23.
Zurück zum Zitat Legro RS, Arslanian SA, Ehrmann DA et al (2013) Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 98:4565–4592 CrossRef Legro RS, Arslanian SA, Ehrmann DA et al (2013) Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 98:4565–4592 CrossRef
24.
Zurück zum Zitat Onway G, Dewailly D, Diamanti-Kandarakis E et al (2014) The poly-cystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol 171:P1–P29 CrossRef Onway G, Dewailly D, Diamanti-Kandarakis E et al (2014) The poly-cystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol 171:P1–P29 CrossRef
25.
Zurück zum Zitat Sprung VS, Cuthbertson DJ, Pugh CJ, Aziz N, Kemp GJ, Daousi C, Green DJ, Cable NT, Jones H (2013) Exercise training in polycystic ovarian syndrome enhances flow-mediated dilation in the absence of changes in fatness. Med Sci Sports Exerc 45(12):2234–2242 CrossRef Sprung VS, Cuthbertson DJ, Pugh CJ, Aziz N, Kemp GJ, Daousi C, Green DJ, Cable NT, Jones H (2013) Exercise training in polycystic ovarian syndrome enhances flow-mediated dilation in the absence of changes in fatness. Med Sci Sports Exerc 45(12):2234–2242 CrossRef
26.
Zurück zum Zitat Adashi EY, Barri PN, Berkowitz R, Braude P, Bryan E, Carr J et al (2003) Infertility therapyassociated multiple pregnancies (births): an ongoing epidemic. Reprod Biomed Online 7(5):515–542 CrossRef Adashi EY, Barri PN, Berkowitz R, Braude P, Bryan E, Carr J et al (2003) Infertility therapyassociated multiple pregnancies (births): an ongoing epidemic. Reprod Biomed Online 7(5):515–542 CrossRef
27.
Zurück zum Zitat Kousta E, White D, Franks S (1997) Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update 3(4):359–365 CrossRef Kousta E, White D, Franks S (1997) Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update 3(4):359–365 CrossRef
28.
Zurück zum Zitat Kar S (2012) Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial. J Hum Reprod Sci 5(3):262 CrossRef Kar S (2012) Clomiphene citrate or letrozole as first-line ovulation induction drug in infertile PCOS women: A prospective randomized trial. J Hum Reprod Sci 5(3):262 CrossRef
29.
Zurück zum Zitat Legro RS, Dodson WC, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI,Gnatuk CL, Estes SJ, Fleming J, Allison KC, Sarwer DB (2015) Randomized controlled trial of preconception interventions in infertile women with polycystic ovary syndrome. J Clin Endocrinol Metab 100(11):4048–4058 CrossRef Legro RS, Dodson WC, Kris-Etherton PM, Kunselman AR, Stetter CM, Williams NI,Gnatuk CL, Estes SJ, Fleming J, Allison KC, Sarwer DB (2015) Randomized controlled trial of preconception interventions in infertile women with polycystic ovary syndrome. J Clin Endocrinol Metab 100(11):4048–4058 CrossRef
30.
Zurück zum Zitat Yanovski SZ (2000) Dieting and the development of eating disorders in overweight and obeseadults. Arch Intern Med 160(17):2581–2589 CrossRef Yanovski SZ (2000) Dieting and the development of eating disorders in overweight and obeseadults. Arch Intern Med 160(17):2581–2589 CrossRef
31.
Zurück zum Zitat Himelein MJ, Thatcher SS (2006) Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 61(11):723–732 CrossRef Himelein MJ, Thatcher SS (2006) Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 61(11):723–732 CrossRef
32.
Zurück zum Zitat Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, et al (2019) Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and metaanalysis. Syst Rev 8(1):51 CrossRef Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I, et al (2019) Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and metaanalysis. Syst Rev 8(1):51 CrossRef
33.
Zurück zum Zitat Najafi PZ, Noghabi SP, Afzali N, Mohammadzadeh S (2020) Comparing the effect of clomiphene citrate and letrozole on ovulation induction in infertile women with polycystic ovary syndrome. JPMA J Pak Med Assoc 70(2):268–271 PubMed Najafi PZ, Noghabi SP, Afzali N, Mohammadzadeh S (2020) Comparing the effect of clomiphene citrate and letrozole on ovulation induction in infertile women with polycystic ovary syndrome. JPMA J Pak Med Assoc 70(2):268–271 PubMed
34.
Zurück zum Zitat Cao SF, Hu WL, Wu MM, Jiang LY (2017) Effects of exercise intervention on preventing letrozole-exposed rats from polycystic ovary syndrome. Reprod Sci 24(3):456–462 CrossRef Cao SF, Hu WL, Wu MM, Jiang LY (2017) Effects of exercise intervention on preventing letrozole-exposed rats from polycystic ovary syndrome. Reprod Sci 24(3):456–462 CrossRef
35.
Zurück zum Zitat Cutler DA, Shaw AK, Pride SM, Bedaiwy MA, Cheung AP (2018) A randomized controlled trial comparing lifestyle intervention to letrozole for ovulation in women with polycystic ovary syndrome: a study protocol. Trials 19(1):1–7 CrossRef Cutler DA, Shaw AK, Pride SM, Bedaiwy MA, Cheung AP (2018) A randomized controlled trial comparing lifestyle intervention to letrozole for ovulation in women with polycystic ovary syndrome: a study protocol. Trials 19(1):1–7 CrossRef
Metadaten
Titel
Pregnancy outcome in PCOS patients: The effects of letrozol combined with exercise
verfasst von
Golshan Manteghi
Associate professor Zahra Shahraki
Maryam Nakhaie Moghadam
Assistant professor Mohammad Hosein Ghanbarpour
Publikationsdatum
12.08.2021
Verlag
Springer Vienna
Erschienen in
Journal für Klinische Endokrinologie und Stoffwechsel / Ausgabe 3/2021
Print ISSN: 1998-7773
Elektronische ISSN: 1998-7781
DOI
https://doi.org/10.1007/s41969-021-00142-z