Polycystic Ovarian Syndrome (PCOS) is a condition that involves a combination of symptoms including irregular or absent cycles and male-type hormone (androgen) symptoms, Many women with PCOS also have difficulty controlling their weight. Treaments recommended for PCOS vary widely ranging from drugs like metformin designed to reduce resistance to the hormone insulin which is thought to be a cause of the condition, to drugs to induce ovulation such as clomiphene to lifestyle changes such as significant weight loss.
But which is most effective? A study in the July 2010 edition of Fertility and Sterility compared metformin, clomiphene, metformin and clomiphene and weight loss. The clinical pregnancy rate was 12.2% in clomiphene group, 14.4% in metformin group, 14.8% in clomiphene + metformin group, and 20% in lifestyle modification group. The lifestyle modification group achieved a significant reduction in waist circumference, total androgen, and lipid profile, not only improving their fertility, but general health as well.
The problem is that very few patients are able to lose enough weight to achieve a pregnancy with lifestyle modification alone and most need to also use the drugs. But if they can achieve it, their fertility and general health will benefit substantially.