Bariatric Surgery versus Dieting Regimen and Lifestyle change as a modality to improve Ovarian Function in Clomiphene-resistant PCOS Women

Sakr, Ahmed E.; Abdul Wahab, Shereen M.; Sakr, Basma; Abdelfattah, Mohamed F.

doi:10.21608/svuijm.2023.190053.1511

Bariatric Surgery versus Dieting Regimen and Lifestyle change as a modality to improve Ovarian Function in Clomiphene-resistant PCOS Women

Document Type : Original research articles

Authors

¹ Department of General Surgery, Benha Teaching Hospital, Benha, Egypt

² Department of Community, Faculty of Medicine, Benha University, Benha, Egypt

³ Department of Obstetrics and Gynecology, Faculty of Medicine, Benha University, Benha, Egypt

10.21608/svuijm.2023.190053.1511

Abstract

Background: Obesity is worldwide spreading epidemic and deleteriously affects the metabolic and reproductive functions of females. The results of therapeutic lines provided for obese citrate-resistant women with polycystic ovary syndrome (CCR-POCS) were variable and discrepant.
Objectives: Evaluation of the effects of weight reduction programs on the ovulatory function of obese CCR-POCS women in comparison to bariatric surgery
Patients and Methods: 135 obese CCR-PCOS women were randomly divided into group I assigned for bariatric surgery, and groups II and III that followed dieting regimen, and lifestyle change with or without insulin sensitizer, respectively. Body mass index (BMI), Homeostasis Model Assessment of Insulin resistance (HOMA-IR) score and serum levels of testosterone and Ferriman-Gallwey (FG) hirsutism score were determined at enrolment (Pre-intervention) and 6-m later (Post-intervention). The study outcome is the frequency of post-intervention ovulation and regular menstrual cycles.
Results: Post-intervention BMI, HOMA-IR, estimated serum levels of testosterone, and FG score were significantly decreased in all patients than pre-intervention data with significantly higher change in women of group I compared to other groups.During 6-m follow-up after the intervention, 43 women (31.9%) got a regular menstrual cycle with significantly higher frequency among women of group I compared to other groups.
Conclusion: Weight reduction interventions might ameliorate the deleterious effects of obesity and insulin resistance on ovarian functions. Bariatric surgery allowed significant weight reduction, decreased hyperandrogenemia, and improved ovarian function. Weight reduction regimens, lifestyle changes, and insulin sensitizers are effective alternatives whenever surgery is contraindicated or refused by patients.

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