Study question What is the spontaneous pregnancy rate in infertile polycystic ovary syndrome (PCOS) women with obesity after the weight loss program in womoen who achieve ≥ 5% BMI reduction? Summary answer Spontaneous pregnancy rate in infertile PCOS women is 29.4 % after the end of the weight loss program and reduction of BMI for ≥ 5%. What is known already PCOS affects 6 to 15% of reproductive age women and is the most common cause of anovulatory infertility. Twenty-five to 75 % of women with PCOS are overweight (BMI >25 kg/m2) or obese (BMI >30 kg/m2). Obesity aggravates symptoms of PCOS. Women with obesity and women with PCOS have lower spontaneous and IVF pregnancy rates. Pregnant women with PCOS and obesity have higher incidence of pregnancy-associated complications. Weight reduction of even 5% improves metabolic and hormonal profile as well as reproductive functions and weight reduction through lifestyle modification is the treatment of choice for overweight and obese women with PCOS. Study design, size, duration Twenty-seven infertile PCOS women with BMI >30 kg/m2 were prospectively included to the study. They attended a weight loss program prior to inclusion to IVF procedures. The program lasted for 8-12 consecutive weeks. Participants/materials, setting, methods Twenty-seven infertile women, aged less than 38 years, with PCOS and obesity were prospectively included to the weight loss program. The program consisted of lifestyle modifications (diet with daily caloric deficit) and physical exercise. Group trainings were held twice a week and were designed as circuit interval trainings. Individual aerobic activity (walking, brisk walking, cycling, walking up the hill) were also performed twice a week. Main results and the role of chance All women completed the prescribed weight loss program. Mean body weight before the program (106.43 kg ± 15.09 kg) was significantly (p < 0.001) higher than after the program (100.63 kg ± 14.67 kg). Mean BMI prior to the start was 37.65 ± 5.1 kg/m2 and after the end of the program 35.68 ± 4.9 kg/m2. The difference was statistically significant (p < 0.001). Of 27 included women, 17 (62.9 %) achieved the desirable BMI reduction of ≥ 5%. Of women who reduced their BMI by ≥ 5%, 5 (29.4 %) conceived spontaneously in three months after the end of the weight loss program. All other were included to IVF procedures. Besides weight loss, significantly more women reported on having healthier eating habits, started to exercise regularly, and improved their sleep after the end of the weight loss program. Limitations, reasons for caution The limitation of the present study is a relatively small sample size. Wider implications of the findings Weight loss represents an important approach towards treatment of obese infertile PCOS women prior to inclusion to IVF procedures. Almost 30 % of women who achieved the desirable BMI reduction conceived spontaneously. They were therefore spared of IVF procedures which has a beneficial health, psychological as well as financial impact. Trial registration number NCT04989244

中文翻译：

---

P-576 肥胖的不孕 PCOS 女性减肥计划后的自然妊娠率

研究问题 肥胖的不孕多囊卵巢综合征 (PCOS) 女性在体重减轻计划后实现 BMI 降低 ≥ 5% 的自然妊娠率是多少？总结答案 在减肥计划结束且 BMI 降低 ≥ 5% 后，不孕 PCOS 女性的自然妊娠率为 29.4%。已知的 PCOS 影响 6% 到 15% 的育龄妇女，并且是无排卵性不孕症的最常见原因。25% 到 75% 的 PCOS 女性超重（BMI > 25 kg/m2）或肥胖（BMI > 30 kg/m2）。肥胖会加重 PCOS 的症状。肥胖女性和 PCOS 女性的自发和体外受精妊娠率较低。患有 PCOS 和肥胖的孕妇发生妊娠相关并发症的发生率较高。即使体重减轻 5% 也能改善新陈代谢和激素水平以及生殖功能，通过改变生活方式来减轻体重是 PCOS 超重和肥胖女性的首选治疗方法。研究设计、规模、持续时间 27 名 BMI > 30 kg/m2 的不孕 PCOS 女性被前瞻性纳入研究。在加入体外受精程序之前，他们参加了一个减肥计划。该计划持续了连续 8-12 周。参与者/材料、环境、方法 27 名年龄小于 38 岁、患有 PCOS 和肥胖症的不孕妇女被前瞻性纳入减肥计划。该计划包括改变生活方式（每日热量不足的饮食）和体育锻炼。团体训练每周举行两次，设计为循环间歇训练。每周进行两次个人有氧运动（步行、快走、骑自行车、上山）。主要结果和机会的作用 所有女性都完成了规定的减肥计划。程序前的平均体重 (106.43 kg ± 15.09 kg) 显着 (p < 0.001) 高于程序后 (100.63 kg ± 14.67 kg)。开始前的平均 BMI 为 37.65 ± 5.1 kg/m2，项目结束后为 35.68 ± 4.9 kg/m2。差异具有统计学意义（p＜0.001）。在纳入的 27 名女性中，17 名 (62.9 %) 实现了 ≥ 5% 的理想 BMI 降低。在 BMI 降低 ≥ 5% 的女性中，有 5 名 (29.4 %) 在减肥计划结束后的三个月内自然受孕。所有其他都包括在体外受精程序中。除了减肥，在减肥计划结束后，更多的女性报告说拥有更健康的饮食习惯，开始定期锻炼，并改善了睡眠。局限性，谨慎的原因 本研究的局限性在于样本量相对较小。研究结果的更广泛意义 减肥代表了在纳入 IVF 程序之前治疗肥胖不育 PCOS 女性的重要方法。几乎 30% 达到理想 BMI 降低的女性自然受孕。因此，他们免于接受具有有益健康、心理和财务影响的体外受精程序。试用注册号NCT04989244 谨慎的理由 本研究的局限性在于样本量相对较小。研究结果的更广泛意义 减肥代表了在纳入 IVF 程序之前治疗肥胖不育 PCOS 女性的重要方法。几乎 30% 达到理想 BMI 降低的女性自然受孕。因此，他们免于接受具有有益健康、心理和财务影响的体外受精程序。试用注册号NCT04989244 谨慎的理由 本研究的局限性在于样本量相对较小。研究结果的更广泛意义 减肥代表了在纳入 IVF 程序之前治疗肥胖不育 PCOS 女性的重要方法。几乎 30% 达到理想 BMI 降低的女性自然受孕。因此，他们免于接受具有有益健康、心理和财务影响的体外受精程序。试用注册号NCT04989244 因此，他们免于接受具有有益健康、心理和财务影响的体外受精程序。试用注册号NCT04989244 因此，他们免于接受具有有益健康、心理和财务影响的体外受精程序。试用注册号NCT04989244