nach oben

Journal für Endokrinologie, Diabetologie und Stoffwechsel

Erschienen in:

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 Endokrinologie, Diabetologie und Stoffwechsel | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten

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.

Vorheriger Artikel Neuroendokrine Regulation des menschlichen Energiestoffwechsels

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.e25CrossRef

Melo AS, Ferriani RA, Navarro PA (2015) Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clinics 70(11):765–769CrossRef

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):e46544CrossRef

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):4048–4058CrossRef

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):246–249CrossRef

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 77:96–104CrossRef

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):604–612PubMed

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):1386e1CrossRef

Kitzinger C, Willmott J (2002) ‘The thief of womanhood’: women’s experience of polycystic ovarian syndrome. Soc Sci Med 54(3):349–361CrossRef

10.

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):638–651CrossRef

11.

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):2038–2049CrossRef

12.

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):642–650CrossRef

13.

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):1966–1982CrossRef

14.

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):1379–1384CrossRef

15.

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):1475–1487CrossRef

16.

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):860–866CrossRef

17.

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):20–25CrossRef

18.

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):1194–1202CrossRef

19.

Green DJ (2009) Exercise training as vascular medicine: direct impacts on the vasculature in humans. Exerc Sport Sci Rev 37(4):196–202CrossRef

20.

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–H2687CrossRef

21.

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):722–730CrossRef

22.

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:i3857CrossRef

23.

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 98:4565–4592CrossRef

24.

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–P29CrossRef

25.

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):2234–2242CrossRef

26.

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):515–542CrossRef

27.

Kousta E, White D, Franks S (1997) Modern use of clomiphene citrate in induction of ovulation. Hum Reprod Update 3(4):359–365CrossRef

28.

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):262CrossRef

29.

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):4048–4058CrossRef

30.

Yanovski SZ (2000) Dieting and the development of eating disorders in overweight and obeseadults. Arch Intern Med 160(17):2581–2589CrossRef

31.

Himelein MJ, Thatcher SS (2006) Polycystic ovary syndrome and mental health: A review. Obstet Gynecol Surv 61(11):723–732CrossRef

32.

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):51CrossRef

33.

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):268–271PubMed

34.

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):456–462CrossRef

35.

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):1–7CrossRef

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 Endokrinologie, Diabetologie und Stoffwechsel / Ausgabe 3/2021
Print ISSN: 3004-8915
Elektronische ISSN: 3004-8923
DOI: https://doi.org/10.1007/s41969-021-00142-z

Springer Medizin Österreich

Abstract

Introduction

Method

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2021

Gestationsdiabetes und polyzystisches Ovarialsyndrom

Editorial

Angeborene Adipositasformen und Therapien

Neuroendokrine Regulation des menschlichen Energiestoffwechsels

Kongenitaler Hyperinsulinismus