Improvement of Polycystic Ovary Syndrome Symptoms in Obese Patients

Polycystic ovary syndrome (PCOS) causes normogonadotrophic anovulation, where women experience abnormal and irregular ovulations due to dysfunctions in the hypothalamic-pituitary that ensure normal levels of estradiol are maintained. This study aims to investigate the improvement of PCOS symptoms in obese patients after undergoing bariatric surgery.

We conducted a retrospective study at The First Hospital of Hebei Medical University from 2020 to 2022. We recruited 65 females; the inclusion criteria involved patients who were obese and experiencing infertility issues due to PCOS, patients who consented to undergo bariatric surgery, patients who were aged 22 years to 40 years, and patients who had a post-surgical BMI of ≤ 35 kg/m2. We excluded patients with medical disorders and complications, aged 40 years and above, and patients who showed a post-surgical operation BMI of greater than 35 kg/m2.

The patients recorded an average pre-operating BMI of 44 kg/m2 with a mean age of 28 years. Most participants had an average menstrual cycle of 60 to 90 days, with 44% of patients reporting normal menstruation. At 6 months, post-surgery, the average level of prolactin was 11.39 ng/mL, progesterone was 0.4ng/dL, SHBG at 24 nmol/L, estradiol at 24.6 pg/mL, testosterone at 34 pg/mL, LH at 10.2 mIU/ml and FSH at 5.6 mIU/ml.

Bariatric surgery enhances a reduction in body weight due to lowering BMI levels of serum and total testosterone. The increased sensitivity to insulin reduces resistance to insulin and enhances regulation of hormones. Ovulation and menstrual cycle were restored in women with PCOS due to weight loss and positive regulation of hormones. Moreover, the effects of chronic low-grade inflammations were eliminated due to a significant reduction in the adipose mass and enhanced metabolic parameters.

We observed that bariatric surgery improved PCOS symptoms in obese women. Bariatric surgery combined with sustainable weight loss, shows promising improvements in menstrual regularity, hormonal balance, fertility and pregnancy rates for obese women with PCOS, potentially offering them a valuable option for achieving conception.