A recent study in the journal Nutrients examines the impact of dietary interventions on the success of in vitro fertilization (IVF) in women with a high body mass and polycystic ovarian syndrome (PCOS).
Study: The impact of nutritional therapy in the management of overweight/obese PCOS patient candidates for IVF. Image Credit: Freebird7977 / Shutterstock.com
Introduction
Polycystic ovarian syndrome (PCOS) is a metabolic-reproductive disease that is the most common hormonal disorder affecting females. In about 75% of women with PCOS, ovulation is either partially or entirely disrupted, thus increasing the risk of anovulatory infertility in affected women.
PCOS is also associated with a higher risk of metabolic dysfunction, including insulin resistance, type 2 diabetes, metabolic syndrome, and cardiovascular disease (CVD). This increased risk can be attributed to greater fat deposition beneath the skin and in the abdomen, likely due to increased androgen levels.
Excessive body mass is known to reduce the efficacy of assisted reproduction technologies (ART) like IVF. A high body mass index (BMI) is associated with a seven-fold greater risk of adverse effects such as ovarian hyperstimulation syndrome (OHSS) during IVF. Ovulation induction is also more difficult with a higher BMI.
These effects may be attributed to the relative resistance of the ovary to stimulation by follicle-stimulating hormone (FSH), which requires higher levels of FSH to be achieved for successful follicle development. This process also yields fewer oocytes and lower serum estradiol levels compared to non-PCOS women.
Other subtle hormonal alterations may underlie the observed deterioration in oocyte and embryo quality and rate of implantation. This affects the rate of successful IVF and obstetric outcomes. For example, the rates of miscarriage, congenital anomalies, preterm delivery, and intrauterine death are all increased among obese or overweight mothers.
Mothers with a high BMI are also more likely to have children with a higher long-term risk of several chronic conditions such as diabetes, stroke and other CVDs, cognitive dysfunction, and…