Choice of stimulation in polycystic ovarian syndrome: the influence of obesity

Obesity modifies insulin sensitivity and gonadotrophins dynamics, and is associated with disorders of spontaneous ovulation. High concentrations of leptin are possibly a link between weight and spontaneous ovulation. Weight excess in polycystic ovary syndrome (PCOS) patients increases hyperinsulinae...

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Bibliographic Details
Published in:Human reproduction (Oxford) 1997-10, Vol.12 (suppl-1), p.88-96
Main Authors: Galtier-Dereure, F., Pujol, P., Dewailly, D., Bringer, J.
Format: Article
Language:English
Subjects:
Clomiphene - therapeutic use
clomiphene citrate
Female
Fertility Agents, Female - therapeutic use
Humans
Infertility, Female - drug therapy
Infertility, Female - etiology
Infertility, Female - therapy
leptin
obesity
Obesity - complications
Obesity - physiopathology
Obesity - therapy
ovulation induction
Ovulation Induction - methods
polycystic ovaries
Polycystic Ovary Syndrome - drug therapy
Polycystic Ovary Syndrome - physiopathology
Polycystic Ovary Syndrome - therapy
Weight Loss
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Summary:Obesity modifies insulin sensitivity and gonadotrophins dynamics, and is associated with disorders of spontaneous ovulation. High concentrations of leptin are possibly a link between weight and spontaneous ovulation. Weight excess in polycystic ovary syndrome (PCOS) patients increases hyperinsulinaemia, which may result in altered follicular maturation. Obese PCOS women are characterized by a decreased efficiency of the different stimulation treatments. Although clomiphene resistance is not associated with obesity, the dose of clomiphene required to achieve ovulation is positively correlated with body weight. Obese PCOS women also require higher doses of gonadotrophins than their lean counterparts, with ultimately poorer results in pulsatile gonadotrophin releasing hormone-stimulated cycles. The first stage in the optimal management of obese PCOS anovulatory women is a weight loss programme, which helps to correct the clinical and endocrine abnormalities.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/12.suppl_1.88