How are PCOS and obesity related?

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How are PCOS and obesity related?
Dr. Laurence Jacobs, Fertility Centers of Illinois: The link between PCOS and obesity is quite significant. Even though not every woman with PCOS has obesity; probably, maybe 70 percent do. But the underlying problem with both of those is the insulin resistance.
In other words, everybody with PCOS and virtually everybody with obesity has the underlying problem with insulin resistance.
In other words, they overcompensate and produce excessive insulin, because their body does not handle insulin properly. And this underlying problem of the excessive insulin is what leads to hormone changes in the pituitary, the hypothalamus, and eventually it affects the hormone production. They make excessive androgens or male hormones. All of this translates into poor egg quality.
So, whether one has PCOS or they have obesity, we tackle the problem the same way.
In other words, there are really three different areas that can be helpful to reduce the insulin and each one of these acts independently.
So, for example, weight loss with proper nutrition, good carbs, low carbs, makes a big difference in producing less insulin. Secondly, it’s drugs or medication. Metformin, for example, can lower insulin levels. Inositol, a vitamin, can do the same thing. And exercise.
And the problem is that each one of these act independently.
So, if one is taking medication, that doesn’t mean they shouldn’t still eat properly and exercise.
Exercise, good carbs, low carbs, medication, all of these are going to contribute to better pregnancy rate.
And what we have found is that at least a 5- to 10-percent weight loss will translate significantly into better pregnancy rates. And that’s regardless of whether someone is trying on their own and trying to achieve a spontaneous pregnancy or at the other extreme with IVF, in vitro fertilization, we see far better eggs and therefore we see better pregnancy rate.
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