Obesity, polycystic ovary syndrome, infertility treatment: Lifestyle modification is paramount

doi:10.1136/bmj.332.7541.609-a

BMJ 2006;332:609 (11 March), doi:10.1136/bmj.332.7541.609-a

Letter

Obesity, polycystic ovary syndrome, infertility treatment

Lifestyle modification is paramount

The first 150 words of the full text of this article appear below.

EDITOR—We agree with Balen et al that lifestyle modification,including effective exercise regimens and dietary advice, shouldbe the first line of treatment in women with polycystic ovarysyndrome.¹ Our Cochrane review has been widely cited as supportingthe use of metformin in women with this syndrome, but like Balenet al we too concluded that metformin should be used as an adjuvantto general lifestyle improvements and not as a replacement forthem.² An update of the Cochrane review should be availablethis year.

The complications of obesity both in infertility treatment andin subsequent pregnancy are well known.³ However, lifestylemodifications can bring about beneficial metabolic changes despiteonly modest reductions in weight, and body mass index (BMI)may not be a sensitive enough measure to detect clinically significantchanges in metabolic parameters, with waist circumference beinga better marker in women.⁴ More research is needed . . . [Full text of this article]

Jonathan M Lord, consultant in obstetrics and gynaecology

Royal Cornwall Hospital, Truro, Cornwall TR1 3LJ jonathan.lord@pms.ac.uk

Robert Norman, professor

Research Centre for Reproductive Health, Discipline of Obstetrics and Gynaecology, University of Adelaide, Queen Elizabeth Hospital, 28 Woodville Road, Woodville, SA 5011, Australia

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