Polycystic ovary syndrome: relation with diet and exercise - systematic review of randomized clinical trials

Revisão - n´úmero e225513 - publicado 19 de setembro de 2023

Authors

DOI:

https://doi.org/10.33233/rbfex.v22i1.5513

Keywords:

obesity, infertility, healthy lifestyle

Abstract

Introduction: Women with polycystic ovary syndrome tend to present overweight/obese and have worst results for reproduction. Knowing that the effects of weight loss have a positive factor in the prognosis of fertility, the summary of published articles about the changes of lifestyle modification has on ovulation/pregnancy is important for health professionals to reinforce the method as a first-line therapeutic strategy. Aim: This study aimed to describe the alterations of lifestyle modifications on ovulation/pregnancy in overweight/obese women with polycystic ovary syndrome. Methods: It is a systematic review of randomized clinical trials based on the Preferred Reporting Items guideline for Systematic Review and Meta-analyses (PRISMA), registered in PROSPERO under id: CRD42023421853. Publications between 2010-2021 in Portuguese or English researched in databases: Pubmed, Scielo, and Lilacs were included. The interest variables analyzed were: age, body mass index, lifestyle modification, comorbidities, and reproductive outcome (ovulation/pregnancy). Results: 15 studies were screened through the database, and four were manually accessed through the reference list of the selected articles. After analyzing the eligibility criteria, five studies were considered relevant and included in this review, all randomized clinical trials. Conclusion: The lifestyle modification treatment implementation of overweight/obese women with polycystic ovary syndrome improved ovulation rate and menstrual regularity.

Author Biographies

Marina Amorim Santos, UniFTC

Centro Universitário UniFTC, Salvador, BA, Brasil

Nathália Rocha Rios Mendes Machado, UniFTC

Centro Universitário UniFTC, Salvador, BA, Brasil

Paulo Gabriel Barbosa de Carvalho, UniFTC

Centro Universitário UniFTC, Salvador, BA, Brasil

Márcia Farias Moreira, UniFTC

Centro Universitário UniFTC, Salvador, BA, Brasil

Francisco Paulo Cerqueira Mota, UniFTC

Centro Universitário UniFTC, Salvador, BA, Brasil

References

Cooney LG, Dokras A. Beyond fertility: polycystic ovary syndrome and long-term health. Fertil Steril. 2018;110(5):794-809. doi: 10.1016/j.fertnstert.2018.08.021

Andrade VHL, Mata AMOF, Borges RS, Silva DRC, Martins LM, Ferreira PMP, et al. Current aspects of polycystic ovary syndrome: A literature review. Rev Assoc Med Bras. 2016;62(9):867-871. doi: 10.1590/1806-9282.62.09.867

Fernandes CE, Sá MFS. Tratado de Ginecologia FEBRASGO. 1 ed. São Paulo: Elsevier; 2018.

Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI. Ginecologia de Willians. 2ª ed. Porto Alegre: Artmed; 2014.

Joham AE, Palomba S, Hart R. Polycystic ovary syndrome, obesity, and pregnancy. Semin Reprod Med. 2016;34(2):93-101. doi: 10.1055/s-0035-1571195

Carneiro JS, Rosa e Silva AC. Complicações gestacionais e perinatais em mulheres com síndrome dos ovários policísticos. Femina. [Internet]. 2021 [citado 2022 mar 12];49(9):530-6. Disponível em: https://www.febrasgo.org.br/media/k2/attachments/FeminaZ2021Z49Z09ZWEBZ1.pdf

Manual de ginecologia endócrina. São Paulo: FEBRASGO; 2015 [internet]. Citado 2022 maio 12]. Disponível em: em:https://mediacdns3.ulife.com.br/PAT/Upload/2005426/disparadorManual_Ginecologia_Endocrina_20200827140253.pdf

Cena H, Chiovato L, Nappi RE. Obesity, polycystic ovary syndrome, and infertility: a new avenue for GLP-1 receptor agonists. J Clin Endocrinol Metab. 2020;1;105(8):e2695-709. doi: 10.1210/clinem/dgaa285

Azevedo JD, Costa EC, Micussi MTABC, Sá JCF. Modificações do estilo de vida na síndrome dos ovários policísticos: papel do exercício físico e importância da abordagem multidisciplinar. Rev Bras Ginecol Obstet. 2008;30(5):261-67. doi: 10.1590/S0100-72032008000500009

Doherty DA, Newnham JP, Bower C, Hart R. Implications of polycystic ovary syndrome for pregnancy and for the health of offspring. Obstet Gynecol 2015;125(6):1397-406. doi: 10.1097/AOG.0000000000000852

Campos AE, Leão MEB, Souza MA. O impacto da mudança do estilo de vida em mulheres com síndrome dos ovários policísticos. REAS 2022;13(2):e4354. doi: 10.25248/reas.e4354.2021

Colégio Brasileiro de Medicina do Estilo de Vida [Internet]. Medicina do estilo de Vida [citado 2022 maio 14]. Disponível em: https://cbmev.org.br/medicina-do-estilo-de-vida/

Guia de Atividade Física para a População Brasileira [Internet]. Ministério da Saúde [citado 2022 maio 14]. Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/guia_atividade_fisica_populacao_brasileira.pdf

Galvão TF, Pansani TSA, Harrad D. Principais itens para relatar revisões sistemáticas e meta-análises: A recomendação PRISMA. Epidemiol Serv Saúde 2015;24(2):335-42. doi: 10.5123/S1679-49742015000200017

Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377-84. doi: 10.1136/jech.52.6.377

Palomba S, Falbo A, Giallauria F, Russo T, Rocca M, Tolino A, Zullo F, Orio F. Six weeks of structured exercise training and hypocaloric diet increases the probability of ovulation after clomiphene citrate in overweight and obese patients with polycystic ovary syndrome: a randomized controlled trial. Hum Reprod. 2010;25(11):2783-91. doi: 10.1093/humrep/deq254

Nybacka Å, Carlström K, Ståhle A, Nyrén S, Hellström PM, Hirschberg AL. Randomized comparison of the influence of dietary management and/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome. Fertil Steril. 2011;96(6):1508-13. doi: 10.1016/j.fertnstert.2011.09.006

Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, et al. Benefit of delayed fertility therapy with preconception weight loss over immediate therapy in obese women with PCOS. J Clin Endocrinol Metab. 2016;101(7):2658-66. doi: 10.1210/jc.2016-1659

Mutsaerts MA, van Oers AM, Groen H, Burggraaff JM, Kuchenbecker WK, Perquin DA, et al. Randomized trial of a lifestyle program in obese infertile women. N Engl J Med. 2016;374(20):1942-53. doi: 10.1056/NEJMoa1505297

Sim KA, Dezarnaulds GM, Denyer GS, Skilton MR, Caterson ID. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 2014;4(2):61-8. doi: 10.1111/cob.12048

Karimzadeh MA, Javedani M. An assessment of lifestyle modification versus medical treatment with clomiphene citrate, metformin, and clomiphene citrate-metformin in patients with polycystic ovary syndrome. Fertil Steril. 2010;94(1):216-20. doi: 10.1016/j.fertnstert.2009.02.078

Hakimi O, Cameron LC. Effect of exercise on ovulation: a systematic review. Sports Med. 2017;47(8):1555-67. doi: 10.1007/s40279-016-0669-8

Kuchenbecker WKH, Groen H, van Asselt SJ, Bolster JHT, Zwerver J, Slart RHJ, et al. In women with polycystic ovary syndrome and obesity, loss of intra-ab- dominal fat is associated with resumption of ovulation. Hum Reprod. 2011;26:2505-12. doi: 10.1093/humrep/der229

Harrison CL, Lombard CB, Moran LJ, Teede HJ. Exercise therapy in polycystic ovary syndrome: a systematic review. Hum Reprod Update. 2011;17(2):171-83. doi: 10.1093/humupd/dmq045

Pauli JR, Cintra DE, Souza CT, Ropelle ER. Novos mecanismos pelos quais o exercício físico melhora a resistência à insulina no músculo esquelético. Arq Bras Endocrinol Metabol. 2009;53(4):399-408. doi: 10.1590/S0004-27302009000400003

McDonnell R, Hart RJ. Pregnancy-related outcomes for women with polycystic ovary syndrome. Womens Health (Lond). 2017;13(3):89-97. doi: 10.1177/1745505717731971

Rees DA, Jenkins-Jones S, Morgan CL. Contemporary reproductive outcomes for patients with polycystic ovary syndrome: a retrospective observational study. J Clin Endocrinol Metab. 2016;101(4):1664-72. doi: 10.1210/jc.2015-2682

Published

2023-09-19