title: Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet.
abstract: BACKGROUND
  This prospective study evaluated the effect of weight reduction on anthropometric indices and ovarian morphology in anovulatory overweight patients with polycystic ovary syndrome (PCOS).
  
  
  METHODS
  Thirty-three anovulatory overweight patients with PCOS were enrolled in the study. All had patent Fallopian tubes and chronic anovulation: 27 of them were oligo-amenorrhoeic. The partners were normospermic. Patients were prescribed a 1200 kcal/day diet, and physical exercise was recommended. Anthropometric indices and ovarian imaging parameters were assessed at baseline and after weight loss of 5 and 10%.
  
  
  RESULTS
  Twenty-five patients (76%) lost at least 5% of their body weight. Eleven of these patients (33%) reached a 10% decrease in weight. Waist circumference at the umbilical level, hip circumference, four skin folds, body mass index and fatty mass ratio were significantly reduced after 5 and 10% weight loss. Ovarian morphology changed during the diet: we observed a significant reduction in ovarian volume and in the number of microfollicles per ovary. Among the 27 patients with oligo-amenorrhoea, 18 had a resumption of regular cycles and 15 experienced spontaneous ovulation; 10 spontaneous pregnancies occurred in patients who lost at least 5% of their weight.
  
  
  CONCLUSIONS
  Weight loss through a controlled low-calorie diet improves anthropometric indices in obese PCOS patients, reduces ovarian volume and microfollicle number and can restore ovulatory cycles, allowing spontaneous pregnancy.
authors.affiliation: Infertility Unit of the First Department Obstetrics and Gynecology, University of Milan, Via della Commenda 12, 20122 Milan, Italy. piergiorgio.crosignani@unimi.it
authors.forename: Pier Giorgio
authors.initials: PG
authors.lastname: Crosignani
authors.forename: Michela
authors.initials: M
authors.lastname: Colombo
authors.forename: Walter
authors.initials: W
authors.lastname: Vegetti
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Alessio
authors.initials: A
authors.lastname: Gessati
authors.forename: Guido
authors.initials: G
authors.lastname: Ragni
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging; D000328:Adult; D000858:Anovulation / Q000150:complications* / Q000503:physiopathology; D000886:Anthropometry; D001824:Body Constitution; D015992:Body Mass Index; D001835:Body Weight; D004038:Diet, Reducing; D005260:Female; D005298:Fertility; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D011247:Pregnancy; D011446:Prospective Studies; D020127:Recovery of Function; D012885:Skinfold Thickness; D014463:Ultrasonography