A recent study has found that adopting a ketogenic diet (KD) can restore menstrual cycles and significantly enhance pregnancy rates in women suffering from polycystic ovary syndrome (PCOS), offering new hope for those facing infertility challenges.
Published in the journal Frontiers in Nutrition, the research explored the impact of a KD on menstrual regularity and fertility among individuals diagnosed with PCOS. The results revealed that 92% of participants regained regular menstrual cycles after six months on the diet, and among those trying to conceive, the pregnancy rate reached 55.6%.
PCOS is a prevalent condition that affects up to 20% of women of reproductive age and is a leading cause of infertility due to irregular ovulation. A significant number of women with PCOS—up to 75%—are also affected by obesity, which exacerbates hormonal imbalances and disrupts ovulation. While various treatments, including dietary changes and insulin-sensitizing medications, can improve fertility, the ketogenic diet has emerged as a particularly promising option due to its potential for weight loss and metabolic health improvement.
The study aimed to assess the efficacy of a KD in helping women with PCOS restore regular menstruation and achieve pregnancy. Researchers analyzed medical records from a clinic’s electronic system, focusing on women enrolled in a weight management program between 2017 and 2019. This program included monthly group sessions led by dietitians, exercise specialists, and endocrinologists.
Participants followed a strict ketogenic diet, limiting carbohydrate intake to 20 grams per day, with specific guidelines for protein and fat consumption. The study included only those who adhered to the diet for at least three months and excluded women using contraception or those who were postmenopausal. A total of 30 women met the criteria for inclusion.
Throughout the study, participants had monthly check-ups to monitor their weight, overall health, and menstrual cycles. Women requiring additional support were offered metformin and ovulation-inducing medications.
The average age of participants was 31, with an average body mass index (BMI) of 43.4. Notably, 60% of the women were using metformin and expressed a desire to become pregnant.
After six months on the ketogenic diet, 92% of participants reported regular menstrual cycles, and by 15 months, all had achieved this regularity. On average, participants lost 7.1 kg during the study period. Among the 18 women attempting to conceive, 55.6% became pregnant, with 63% doing so within 12 months. Importantly, both groups—those who became pregnant and those who did not—experienced similar weight loss.
The study found that the use of metformin did not significantly influence the restoration of regular menstrual cycles, as all women ultimately regained this regularity, regardless of their medication status. However, pregnancy rates differed: all women not taking metformin achieved pregnancy, compared to 38.5% in the metformin group. Additionally, the use of ovulation induction agents did not significantly enhance pregnancy rates.
For participants with available anti-mullerian hormone (AMH) data, lower AMH levels were associated with difficulties in conceiving, underscoring the hormone’s potential role in fertility outcomes for women with PCOS.
Conclusions
This study suggests that a ketogenic diet may effectively improve menstrual regularity and increase pregnancy rates among women with PCOS. The findings indicate that weight loss and improved insulin sensitivity, both facilitated by the KD, are crucial factors in enhancing fertility for this population.
As one of the first studies to examine the effects of a KD on fertility in women with PCOS, it offers valuable insights. It highlights that even modest weight loss, combined with improvements in insulin resistance, can lead to higher pregnancy rates. However, the study’s small sample size and lack of long-term fertility effects evaluation warrant further investigation.
Future research should include larger sample sizes to confirm the long-term impact of the ketogenic diet on fertility and compare its effects with other dietary strategies. Additionally, exploring the physiological mechanisms behind the KD’s influence on insulin resistance and reproductive hormone regulation could provide deeper understanding of its benefits for fertility.
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