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Semin Reprod Med 2020; 38(06): 342-351
DOI: 10.1055/s-0041-1726866
Review Article

Obesity and the Risk of Infertility, Gestational Diabetes, and Type 2 Diabetes in Polycystic Ovary Syndrome

Stephanie Pirotta 
1   Health and Social Care Unit, SPHPM, Monash University, Victoria, Australia
,
Anju Joham 
2   Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia
3   Department of Diabetes and Vascular Medicine, Monash Health, Victoria, Australia
,
Jessica A. Grieger
4   Adelaide Medical School, University of Adelaide, South Australia, Australia
5   Robinson Research Institute, University of Adelaide, Adelaide, Australia
,
Chau Tien Tay 
2   Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia
,
Mahnaz Bahri-Khomami
2   Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia
,
Marla Lujan 
6   Division of Nutritional Sciences, Cornell University, New York
,
Siew S. Lim 
2   Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia
,
Lisa J. Moran 
2   Monash Centre for Health Research and Implementation, Monash University, Victoria, Australia
› Author Affiliations Funding S.P. received the Post Publication Award from Monash University. L.J.M. received the National Heart Foundation of Australia Future Leader Fellowship from the National Heart Foundation of Australia. S.L. received the Early Career Fellowship from the National Health and Medical Research Council.
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Abstract

This review describes the relationship between obesity and the most common reproductive (infertility) and metabolic (gestational diabetes mellitus [GDM] and type 2 diabetes mellitus [T2DM]) consequences in polycystic ovary syndrome (PCOS). It also describes the vital role of lifestyle management for PCOS. PCOS is a heterogeneous endocrine disorder common in reproductive-age women. Consensus on the exact etiological mechanisms of PCOS is unreached. Overweight or obesity is present in at least 60% of the PCOS population, but the condition occurs irrespective of BMI, with excess BMI increasing both the prevalence and severity of clinical features. Use of lifestyle therapies (nutrition, physical activity, and/or behavioral) for the prevention and management of excess weight gain, infertility, GDM, and T2DM is a vital component of best-practice PCOS care. Lifestyle management is recommended for all women with PCOS as the first-line treatment with or without medications. Due to a lack of high-quality trials demonstrating the efficacy of specific lifestyle approaches, PCOS lifestyle recommendations are as those for the general population. This review summarizes current knowledge relating to obesity and its impact on fertility, GDM, and T2DM. It also summarizes the lifestyle recommendations to best manage these conditions in women with PCOS and obesity.

Keywords

polycystic ovary syndrome - lifestyle management - fertility


Publication History

Article published online:
19 April 2021

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