Does Pre-Treatment Weight Loss Improve Outcomes for PCOS Patients?

Polycystic ovary syndrome (PCOS)is the most common cause of infertility in women. PCOS is often associated with obesity. Obesity, however, is NOT a diagnostic criteria for PCOS, as it can also occur in normal weight women.

At InVia Fertility Specialists, we often encourage our patients who are overweight for their height to lose weight prior to proceeding with fertility treatment. The resultant delay in treatment can be frustrating for patients. However, does pre-treatment weight loss improve outcomes?

This very question was addressed by researchers working with Penn State University's College of Medicine in a large, multi-center trial ("Benefit of Delayed Fertility Therapy With Preconception Weight Loss Over Immediate Therapy in Obese Women With PCOS." Legro, et al; J Clin Endocrinol Metab 2016 Jul;101(7):2658-66).

The researchers compared outcomes in three groups of PCOS patients:

1. Patients who began immediate treatment with a fertility pill (clomiphene citrate, Clomid, CC)
2. Patients who delayed treatment and started on continuous oral contraceptives pills alone
3. Patients who delayed treatment with continuous oral contraceptives and lifestyle modification, including caloric restriction, antiobesity medication, behavioral modification, and exercise

In patients treated immediately with CC, after 4 cycles, the cumulative per-cycle ovulation rate was 44.7% (277/619) and the cumulative live birth rate was 10.2% (19/187). The success rates were similar in the second group – ovulation rate 45% and live birth rate of 8.5%.

In comparison, the third group had significantly better outcomes. The cumulative ovulation rate was lifestyle: 62% (80/129); combined: 64.3% (83/129)) and live birth rate was (lifestyle: 25%; combined: 25.5%).

In PCOS patients, pre-treatment intervention with lifestyle modification resulted in an almost 50% increase in ovulation rate and a more than doubling of the live birth rate!

We Want You to Have the Best Chance at Pregnancy

The evidence in favor of losing weight before fertility treatment is extremely strong. That's why we at InVia often counsel patients who are overweight or obese to lose weight before beginning treatment: because we want you to have a successful, healthy pregnancy.

We offer the Ideal Protein Diet Program as an option to help you achieve weight loss. It is a meal replacement program where you work with a coach to modify your behavior and track progress. Patients who follow the program will often lose 3 – 4 lb. a week without feeling hungry or tired-- some have lost almost 100 pounds!

Even a modest, 20-lb. weight loss can result in a marked increase in success rates during subsequent fertility treatment. Better still, a lot of patients have even conceived naturally during the weight loss process.