Dear DOCTOR Owen:

My gynecologist told me that I have polycystic ovarian syndrome and that I am infertile. I have heard that this condition could be related to obesity and diet. Is it true that infertility can be related to obesity?

Infertile

Dear “Infertile”:

Yes. There is a direct link between obesity and infertility. Polycystic ovarian syndrome is known as insulin resistance syndrome or metabolic syndrome—which makes the body’s tissues very insensitive to your own insulin. The hormone insulin is produced by the pancreas, which enables the body to utilize glucose (sugar) and proteins.

Insulin resistance causes the body’s blood pressure, trigycerides and cholesterol, and blood sugar to increase (diabetes mellitus). Insulin resistance also affects the hormones made by the brain that control ovulation, and can lead to cysts on the ovaries. Many scientists and researchers believe that insulin also causes changes in other hormones—such as the fat hormone leptin—which contribute to obesity and prevent ovulation.

I have many (16 as of this writing) previously deemed infertile patients who become pregnant while they are losing weight. This is apparently due to the body’s improved sensitivity to insulin during dieting. A number of researchers are experimenting with medications that cause the body to become more responsive to its own insulin. Preliminary results are promising that this will overcome the problem of infertility and the obesity associated with polycystic ovarian syndrome and the consequent diseases.

Talk to your infertility specialist about the possibility of going on a very low calorie diet as part of your infertility treatment. Women’s menstrual periods often normalize immediately after they start such diets. These diets use pre-measured food in the 500–800 calorie range. To assure safe nutrition, the food in this low-calorie range must be pre-measured. Your greatest chance of fertility will be while you are on the diet, so get tested frequently for pregnancy. This is further confirmation that the condition is related to both diet and weight.

You will need close control of your diet during pregnancy. After pregnancy, for your health, resume your weight loss down to your lean weight, and enroll in a weight maintenance class forever. Yes—forever! You have a genetic syndrome that can be controlled, but never cured. For the sake of your new family, you must practice excellent dietary methods if you wish to see your children and grandchildren grow up.

The Internet is a good source of information on polycystic ovary syndrome because reports on new studies are published every month. Good luck!