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Liza Haqq, James McFarlane, Gudrun Dieberg, and Neil Smart

Polycystic ovarian syndrome (PCOS) affects 18–22% of women at reproductive age. We conducted a systematic review and meta-analysis evaluating the expected benefits of lifestyle (exercise plus diet) interventions on the reproductive endocrine profile in women with PCOS. Potential studies were identified by systematically searching PubMed, CINAHL and the Cochrane Controlled Trials Registry (1966–April 30, 2013) systematically using key concepts of PCOS. Significant improvements were seen in women receiving lifestyle intervention vs usual care in follicle-stimulating hormone (FSH) levels, mean difference (MD) 0.39 IU/l (95% CI 0.09 to 0.70, P=0.01), sex hormone-binding globulin (SHBG) levels, MD 2.37 nmol/l (95% CI 1.27 to 3.47, P<0.0001), total testosterone levels, MD −0.13 nmol/l (95% CI −0.22 to −0.03, P=0.008), androstenedione levels, MD −0.09 ng/dl (95% CI −0.15 to −0.03, P=0.005), free androgen index (FAI) levels, MD −1.64 (95% CI −2.94 to −0.35, P=0.01) and Ferriman–Gallwey (FG) score, MD −1.01 (95% CI −1.54 to −0.48, P=0.0002). Significant improvements were also observed in women who received exercise-alone intervention vs usual care in FSH levels, MD 0.42 IU/l (95% CI 0.11 to 0.73, P=0.009), SHBG levels, MD 3.42 nmol/l (95% CI 0.11 to 6.73, P=0.04), total testosterone levels, MD −0.16 nmol/l (95% CI −0.29 to −0.04, P=0.01), androstenedione levels, MD −0.09 ng/dl (95% CI −0.16 to −0.03, P=0.004) and FG score, MD −1.13 (95% CI −1.88 to −0.38, P=0.003). Our analyses suggest that lifestyle (diet and exercise) intervention improves levels of FSH, SHBG, total testosterone, androstenedione and FAI, and FG score in women with PCOS.

Open access

M Boering, P R van Dijk, S J J Logtenberg, K H Groenier, B H R Wolffenbuttel, R O B Gans, N Kleefstra, and H J G Bilo

2008 93 1796 – 1803 . ( doi:10.1210/jc.2007-2358 ) 35 Codner E Merino PM Tena-Sempere M. Female reproduction and type 1 diabetes: from mechanisms to clinical findings . Human Reproduction Update 2012 18 568 – 585 . ( doi:10

Open access

Angela Köninger, Philippos Edimiris, Laura Koch, Antje Enekwe, Claudia Lamina, Sabine Kasimir-Bauer, Rainer Kimmig, and Hans Dieplinger

stress on female reproduction: a review . Reproductive Biology and Endocrinology 2012 10 49 . ( doi:10.1186/1477-7827-10-49 ). 24 Blair SA Kyaw-Tun T Young IS Phelan NA Gibney J McEneny J . Oxidative stress and inflammation in lean and

Open access

Mírian Romitti, Vitor C Fabris, Patricia K Ziegelmann, Ana Luiza Maia, and Poli Mara Spritzer

England Journal of Medicine 2001 345 260 – 265 . ( https://doi.org/10.1056/NEJM200107263450406 ) 10.1056/NEJM200107263450406 29 Poppe K Velkeniers B Glinoer D. Thyroid disease and female reproduction . Clinical Endocrinology 2007 66 309

Open access

Rosalie Cabry, Philippe Merviel, Aicha Madkour, Elodie Lefranc, Florence Scheffler, Rachel Desailloud, Véronique Bach, and Moncef Benkhalifa

porcine oocytes and possible mechanisms of action . PLoS ONE 2017 22 e0179861 . ( https://doi.org/10.1371/journal.pone.0179861 ) 53 Zhou YJ Huang HR Zhou J Wang LQ . beta-Cypermethrin exposure affects female reproduction by enhancing

Open access

Kerry V Fanson, Tamara Keeley, and Benjamin G Fanson

-hydroxysteroid dehydrogenase (11βHSD) . Molecular and Cellular Endocrinology 1994 100 55 – 63 . ( doi:10.1016/0303-7207(94)90279-8 ). 4 Brann D Mahesh V . Role of corticosteroids in female reproduction . FASEB Journal 1991 5 2691 – 2698 . ( doi:10.1096/fj

Open access

Michael J Gratz, Stavroula Stavrou, Christina Kuhn, Simone Hofmann, Kerstin Hermelink, Helene Heidegger, Stefan Hutter, Doris Mayr, Sven Mahner, Udo Jeschke, and Aurelia Vattai

://doi.org/10.1016/S1701-2163(16)30420-0 ) 10.1016/S1701-2163(16)30420-0 10 Pestka A Fitzgerald JS Toth B Markert UR Jeschke U . Nuclear hormone receptors and female reproduction. Current Molecular Medicine 2013 13 1066 – 1078 . ( https://doi.org/10

Open access

Lian Hollander-Cohen, Benjamin Böhm, Krist Hausken, and Berta Levavi-Sivan

female reproduction . Fish Physiology and Biochemistry 2014 1849 – 1861 . ( https://doi.org/10.1007/s10695-014-9973-0 ) 36 Moyle WR Campbell RK Myers RV Bernard MP Han Y Wang X . Co-evolution of ligand-receptor pairs . Nature 1994

Open access

Stavroula Stavrou, Michael Gratz, Eileen Tremmel, Christina Kuhn, Simone Hofmann, Helene Heidegger, Mina Peryanova, Kerstin Hermelink, Stefan Hutter, Bettina Toth, Doris Mayr, Sven Mahner, Udo Jeschke, and Aurelia Vattai

-2163(16)30420-0 4 Pestka A Fitzgerald JS Toth B Markert UR Jeschke U . Nuclear hormone receptors and female reproduction. Current Molecular Medicine 2013 13 1066 – 1078 . ( https://doi.org/10.2174/1566524011313070002 ) 23116264 10

Open access

Yao Ye, Aurelia Vattai, Nina Ditsch, Christina Kuhn, Martina Rahmeh, Sven Mahner, Myriam Ripphahn, Roland Immler, Markus Sperandio, Udo Jeschke, and Viktoria von Schönfeldt

Toth B Markert UR Jeschke U. Nuclear hormone receptors and female reproduction . Current Molecular Medicine 2013 13 1066 – 1078 . ( https://doi.org/10.2174/1566524011313070002 ) 23116264 10.2174/1566524011313070002 21 Pestka A Toth B Kuhn C