Structured exercise training plus hypocaloric diet improves ovarian sensitivity to clomiphene citrate in polycystic ovary syndrome (PCOS) patients
Stefano Palomba1, Francesco Giallauria2, Angela Falbo1, Tiziana Russo1, Alessandra Grieco3, Annamaria Colao3, Gaetano Lombardi1 & Francesco Orio3,4
Clomiphene citrate (CC) is the first-line therapy for inducing ovulation in infertile women with polycystic ovary syndrome (PCOS), but about 20% of them results un-responsive. Lifestyle modification programs are effective in restoring ovarian function and improving reproductive outcomes in PCOS patients.
The aim of the present randomized controlled trial was to test the hypothesis that a very short-term intervention consisting in structured exercise training (SET) plus hypocaloric diet improves ovarian response to CC in CC-resistant PCOS patients.
Ninety-six infertile CC-resistant PCOS patients were investigated.
SET plus hypocaloric diet for 6 weeks (group A), 2 weeks of observation followed by one-cycle of CC therapy (group B), and SET plus hypocaloric diet for six weeks plus one-cycle of CC added after the first two weeks (group C).
After intervention, the ovulation rate was significantly (P<0.05) higher in group C in comparison with groups A and B (12/32 (37.5%), 4/32 (12.5%) and 3/32 (9.4%) for group C, A and B, respectively). Compared to baseline, in both group A and C, a significant improvement in clinical and biochemical androgen and insulin sensitivity indexes was observed. In the same two groups, insulin sensitivity indexes were significantly (P<0.05) better than group B.
In conclusion, in CC-resistant PCOS patients, a very short-term intervention consisting of SET plus hypocaloric diet is effective at improving ovarian sensitivity to CC by an acute and body weight independent effect on androgens and insulin resistance.