{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T08:48:47Z","timestamp":1773996527672,"version":"3.50.1"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008586","name":"President\u2019s Council of Cornell Women","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008586","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000199","name":"United States Department of Agriculture","doi-asserted-by":"publisher","award":["8106"],"award-info":[{"award-number":["8106"]}],"id":[{"id":"10.13039\/100000199","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01-HD0937848"],"award-info":[{"award-number":["R01-HD0937848"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R56-HD089962"],"award-info":[{"award-number":["R56-HD089962"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"Abstract<\/jats:title>\n \n STUDY QUESTION<\/jats:title>\n Does weight loss from a hypocaloric dietary intervention improve antral follicle dynamics in women with PCOS?<\/jats:p>\n <\/jats:sec>\n \n SUMMARY ANSWER<\/jats:title>\n During a 3-month hypocaloric dietary intervention, women with PCOS who experienced clinically meaningful weight loss showed more organized antral follicle development including fewer recruitment events, but no change in the overall frequency of selection, dominance, or ovulation.<\/jats:p>\n <\/jats:sec>\n \n WHAT IS KNOWN ALREADY<\/jats:title>\n There is a spectrum of disordered antral follicle development in women with PCOS including excessive follicle recruitment and turnover, decreased frequency of selection and dominance, and failure of ovulation. Lifestyle intervention aimed at weight loss is recommended to improve metabolic health in women with PCOS yet benefits on ovarian follicle development and ovulation are unclear.<\/jats:p>\n <\/jats:sec>\n \n STUDY DESIGN, SIZE, DURATION<\/jats:title>\n This was a prospective, single-arm lifestyle intervention study conducted over 4\u00a0months including a 1-month baseline assessment period and 3-month hypocaloric dietary intervention. Twenty women were allocated to the intervention with 0% attrition.<\/jats:p>\n <\/jats:sec>\n \n PARTICIPANTS\/MATERIALS, SETTING, METHODS<\/jats:title>\n Females, ages 18\u201338\u2009years, with PCOS and obesity (BMI\u2009&gt;\u200930\u2009kg\/m2) underwent every-other-day transvaginal ultrasonography and venipuncture at an academic clinical research unit for 4\u2009months. The number and size of all follicles were evaluated at each study visit, with individual growth profiles plotted retrospectively for follicles that grew to at least 7\u2009mm. Gonadotropin and ovarian steroid hormone concentrations were measured every-other-day. Reproductive, anthropometric, and metabolic status markers were assessed at baseline and at the end of the intervention.<\/jats:p>\n <\/jats:sec>\n \n MAIN RESULTS AND THE ROLE OF CHANCE<\/jats:title>\n Hypocaloric dietary intervention resulted in an average weight loss of 8\u2009\u00b1\u20093% with significant reductions in all anthropometric markers assessed including BMI, waist circumference, total percent fat, and trunk fat mass (all P\u2009&lt;\u20090.05). Of the glucoregulatory and cardiovascular risk markers assessed, only diastolic blood pressure (P\u2009=\u20090.040) and 2-h insulin concentrations following a glucose challenge (P\u2009=\u20090.029) were decreased post-intervention. Antral follicle development appeared more cyclic following the intervention with the frequency of recruitment (P\u2009=\u20090.043), and number of follicles recruited per cohort (P\u2009&lt;\u20090.0001), decreasing with weight loss. By contrast, the frequency of selection, dominance, and ovulation did not change with weight loss (all P\u2009&lt;\u20090.05). When ovulation occurred during the intervention, the size at selection for ovulatory follicles decreased with weight loss (P\u2009&lt;\u20090.0001), whereas maximum luteal progesterone levels increased with weight loss (P\u2009=\u20090.036). Participants (35%) who responded to the intervention with a shortened inter-menstrual interval had lower baseline trunk fat mass (P\u2009=\u20090.048), fasting insulin (P\u2009=\u20090.022), and homeostatic model assessment for insulin resistance (P\u2009=\u20090.017) compared to non-responders.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS, REASONS FOR CAUTION<\/jats:title>\n The duration of the intervention may not have been sufficient to capture an impact of weight loss on ovulatory cyclicity. Analyses were limited to the antral stages of follicle development and any impact of hypocaloric dietary intervention on pre-antral folliculogenesis was not evaluated. The small study sample limits statistical power and generalizability of the findings.<\/jats:p>\n <\/jats:sec>\n \n WIDER IMPLICATIONS OF THE FINDINGS<\/jats:title>\n Short-term hypocaloric dietary intervention did not consistently improve ovulation frequency in women with PCOS despite clinically meaningful weight loss. Counseling related to the benefits of short-term hypocaloric dietary intervention on reproductive health outcomes should be tempered as improvements in ovulation are likely only in those with a more favorable metabolic profile at the onset. Improvements in the early stages of antral follicle development with weight loss suggest potential for longer dietary interventions to improve ovulatory cyclicity in women with PCOS.<\/jats:p>\n <\/jats:sec>\n \n STUDY FUNDING\/COMPETING INTEREST(S)<\/jats:title>\n This research was supported by funds from the President\u2019s Council of Cornell Women, United States Department of Agriculture (Grant No. 8106), and National Institutes of Health (R01-HD0937848, R56-HD089962). F.E.C., B.Y.J., and H.V.B. were supported by doctoral training awards from the National Institutes of Health (5 T32-HD087137, T32-DK007158) and Canadian Institutes of Health Research (Grant No. 146182), respectively. The authors have no competing interests.<\/jats:p>\n <\/jats:sec>\n \n TRIAL REGISTRATION NUMBER<\/jats:title>\n NCT01785719.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/humrep\/deaf169","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T11:53:31Z","timestamp":1755086011000},"page":"2161-2171","source":"Crossref","is-referenced-by-count":4,"title":["Changes in antral follicle dynamics following weight loss in women with polycystic ovary syndrome"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4225-3511","authenticated-orcid":false,"given":"Faith E","family":"Carter","sequence":"first","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7328-7186","authenticated-orcid":false,"given":"Brittany Y","family":"Jarrett","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8419-2824","authenticated-orcid":false,"given":"Noah D","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4538-9554","authenticated-orcid":false,"given":"Nabiha","family":"Zaman","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7522-6395","authenticated-orcid":false,"given":"Alexandra M","family":"Reich","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3504-0856","authenticated-orcid":false,"given":"Keziah A","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-3514","authenticated-orcid":false,"given":"Alexis L","family":"Oldfield","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0964-5097","authenticated-orcid":false,"given":"Heidi","family":"Vanden Brink","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Texas A&M University , College Station, TX,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7203-5814","authenticated-orcid":false,"given":"Marla E","family":"Lujan","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, Cornell University , Ithaca, NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"2025110412213358700_deaf169-B1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.semerg.2021.10.010","article-title":"Lifestyle interventions in women with polycystic ovary syndrome: a scoping systematic review of randomised evidence","volume":"48","author":"Al Wattar","year":"2022","journal-title":"Semergen"},{"key":"2025110412213358700_deaf169-B2","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1161\/01.cir.45.2.310","article-title":"Cardiovascular effects of weight reduction","volume":"45","author":"Alexander","year":"1972","journal-title":"Circulation"},{"key":"2025110412213358700_deaf169-B3","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/jhn.12433","article-title":"Effects of dietary approach to stop hypertension diet on androgens, antioxidant status and body composition in overweight and obese women with polycystic ovary syndrome: a randomised controlled trial","volume":"30","author":"Azadi-Yazdi","year":"2017","journal-title":"J Hum Nutr Diet"},{"key":"2025110412213358700_deaf169-B4","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/s0015-0282(03)00544-2","article-title":"A new model for ovarian follicular development during the human menstrual cycle","volume":"80","author":"Baerwald","year":"2003","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B5","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1095\/biolreprod.103.017772","article-title":"Characterization of ovarian follicular wave dynamics in women","volume":"69","author":"Baerwald","year":"2003","journal-title":"Biol Reprod"},{"key":"2025110412213358700_deaf169-B6","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1002\/uog.1891","article-title":"Form and function of the corpus luteum during the human menstrual cycle","volume":"25","author":"Baerwald","year":"2005","journal-title":"Ultrasound Obstet Gynecol"},{"key":"2025110412213358700_deaf169-B7","doi-asserted-by":"publisher","first-page":"3305","DOI":"10.1007\/s11695-022-06209-3","article-title":"Effects of bariatric surgery on people with obesity and polycystic ovary syndrome: a large single center study from India","volume":"32","author":"Bhandari","year":"2022","journal-title":"Obes Surg"},{"key":"2025110412213358700_deaf169-B8","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1477-7827-3-12","article-title":"Ultrasound image attributes of human ovarian dominant follicles during natural and oral contraceptive cycles","volume":"3","author":"Birtch","year":"2005","journal-title":"Reprod Biol Endocrinol"},{"key":"2025110412213358700_deaf169-B9","doi-asserted-by":"publisher","first-page":"553","DOI":"10.2527\/jas.2007-0570","article-title":"Effect of ovulatory follicle size and expression of estrus on progesterone secretion in beef cows","volume":"86","author":"Busch","year":"2008","journal-title":"J Anim Sci"},{"key":"2025110412213358700_deaf169-B10","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1007\/s40519-021-01223-3","article-title":"Green cardamom plus low-calorie diet can decrease the expression of inflammatory genes among obese women with polycystic ovary syndrome: a double-blind randomized clinical trial","volume":"27","author":"Cheshmeh","year":"2022","journal-title":"Eat Weight Disord"},{"key":"2025110412213358700_deaf169-B11","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1007\/s00404-024-07833-3","article-title":"Six-month randomized, placebo controlled trial of synbiotic supplementation in women with polycystic ovary syndrome undergoing lifestyle modifications","volume":"311","author":"Chudzicka-Struga\u0142a","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"2025110412213358700_deaf169-B12","doi-asserted-by":"publisher","first-page":"1928","DOI":"10.1093\/humrep\/deg367","article-title":"Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet","volume":"18","author":"Crosignani","year":"2003","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B13","doi-asserted-by":"publisher","first-page":"3872","DOI":"10.3390\/nu15183872","article-title":"The effect of a very-low-calorie diet (VLCD) vs. a moderate energy deficit diet in obese women with polycystic ovary syndrome (PCOS)-a randomised controlled trial","volume":"15","author":"Deshmukh","year":"2023","journal-title":"Nutrients"},{"key":"2025110412213358700_deaf169-B14","volume-title":"American Dietetic Association Complete Food and Nutrition Guide","author":"Duyff","year":"2006","edition":"3rd edn"},{"key":"2025110412213358700_deaf169-B15","doi-asserted-by":"publisher","first-page":"173","DOI":"10.3109\/09513590903215581","article-title":"Clinical, metabolic, and endocrine parameters in response to metformin and lifestyle intervention in women with polycystic ovary syndrome: a randomized, double-blind, and placebo control trial","volume":"26","author":"Fux Otta","year":"2010","journal-title":"Gynecol Endocrinol"},{"key":"2025110412213358700_deaf169-B16","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1046\/j.1365-2265.1997.2321049.x","article-title":"Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome","volume":"47","author":"Gilling-Smith","year":"1997","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025110412213358700_deaf169-B17","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1093\/oxfordjournals.humrep.a136365","article-title":"Dynamics of follicular growth in the human: a model from preliminary results","volume":"1","author":"Gougeon","year":"1986","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B18","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1016\/S0015-0282(16)56632-1","article-title":"Endocrine consequences of weight loss in obese, hyperandrogenic, anovulatory women","volume":"61","author":"Guzick","year":"1994","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B19","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.fertnstert.2004.02.104","article-title":"A randomized, 48-week, placebo-controlled trial of intensive lifestyle modification and\/or metformin therapy in overweight women with polycystic ovary syndrome: a pilot study","volume":"82","author":"Hoeger","year":"2004","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B20","doi-asserted-by":"publisher","first-page":"R15","DOI":"10.1530\/REP-16-0385","article-title":"Impact of hypocaloric dietary intervention on ovulation in obese women with polycystic ovary syndrome","volume":"153","author":"Jarrett","year":"2017","journal-title":"Reproduction"},{"key":"2025110412213358700_deaf169-B21","doi-asserted-by":"publisher","first-page":"e3847","DOI":"10.1210\/clinem\/dgaa515","article-title":"Ultrasound characterization of disordered antral follicle development in women with polycystic ovary syndrome","volume":"105","author":"Jarrett","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B22","doi-asserted-by":"publisher","first-page":"321","DOI":"10.4103\/ijem.IJEM_646_17","article-title":"Study of visceral and subcutaneous abdominal fat thickness and its correlation with cardiometabolic risk factors and hormonal parameters in polycystic ovary syndrome","volume":"22","author":"Jena","year":"2018","journal-title":"Indian J Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B23","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1093\/humupd\/dmh010","article-title":"The follicular excess in polycystic ovaries, due to intra-ovarian hyperandrogenism, may be the main culprit for the follicular arrest","volume":"10","author":"Jonard","year":"2004","journal-title":"Hum Reprod Update"},{"key":"2025110412213358700_deaf169-B24","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1093\/humrep\/17.6.1459","article-title":"Luteal phase progesterone excretion in ovulatory women with polycystic ovaries","volume":"17","author":"Joseph-Horne","year":"2002","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B25","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3109\/09513590.2011.589929","article-title":"Evaluation of body fat distribution in PCOS and its association with carotid atherosclerosis and insulin resistance","volume":"28","author":"Karabulut","year":"2012","journal-title":"Gynecol Endocrinol"},{"key":"2025110412213358700_deaf169-B26","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1111\/cen.14098","article-title":"Prevalence of polycystic ovary syndrome in women with severe obesity\u2014effects of a structured weight loss programme","volume":"91","author":"Kataoka","year":"2019","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025110412213358700_deaf169-B27","doi-asserted-by":"publisher","first-page":"613","DOI":"10.1016\/j.jand.2013.11.017","article-title":"Evaluation of web-based, self-administered, graphical food frequency questionnaire","volume":"114","author":"Kristal","year":"2014","journal-title":"J Acad Nutr Diet"},{"key":"2025110412213358700_deaf169-B28","doi-asserted-by":"publisher","first-page":"2505","DOI":"10.1093\/humrep\/der229","article-title":"In women with polycystic ovary syndrome and obesity, loss of intra-abdominal fat is associated with resumption of ovulation","volume":"26","author":"Kuchenbecker","year":"2011","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B29","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1016\/j.fertnstert.2010.12.002","article-title":"The effects of metformin with lifestyle therapy in polycystic ovary syndrome: a randomized double-blind study","volume":"95","author":"Ladson","year":"2011","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B30","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1007\/s11695-024-07273-7","article-title":"Effect of sleeve gastric surgery on body weight and hypothalamic-pituitary axis hormone levels in patients with polycystic ovary syndrome","volume":"34","author":"Li","year":"2024","journal-title":"Obes Surg"},{"key":"2025110412213358700_deaf169-B31","doi-asserted-by":"publisher","first-page":"CD007506","DOI":"10.1002\/14651858.CD007506.pub4","article-title":"Lifestyle changes in women with polycystic ovary syndrome","volume":"3","author":"Lim","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2025110412213358700_deaf169-B32","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1111\/j.1467-789X.2012.01053.x","article-title":"The effect of obesity on polycystic ovary syndrome: a systematic review and meta-analysis","volume":"14","author":"Lim","year":"2013","journal-title":"Obes Rev"},{"key":"2025110412213358700_deaf169-B33","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1016\/j.ultrasmedbio.2010.02.008","article-title":"Grid analysis improves reliability in follicle counts made by ultrasonography in women with polycystic ovary syndrome","volume":"36","author":"Lujan","year":"2010","journal-title":"Ultrasound Med Biol"},{"key":"2025110412213358700_deaf169-B34","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.soard.2021.09.008","article-title":"Effects of bariatric surgery on the menstruation- and reproductive-related hormones of women with obesity without polycystic ovary syndrome: a systematic review and meta-analysis","volume":"18","author":"Lv","year":"2022","journal-title":"Surg Obes Relat Dis"},{"key":"2025110412213358700_deaf169-B35","doi-asserted-by":"publisher","first-page":"492","DOI":"10.3390\/nu11030492","article-title":"Predictors of lifestyle intervention attrition or weight loss success in women with polycystic ovary syndrome who are overweight or obese","volume":"11","author":"Moran","year":"2019","journal-title":"Nutrients"},{"key":"2025110412213358700_deaf169-B36","doi-asserted-by":"publisher","first-page":"3796","DOI":"10.1210\/jc.2007-1188","article-title":"The use of anti-Mullerian hormone in predicting menstrual response after weight loss in overweight women with polycystic ovary syndrome","volume":"92","author":"Moran","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B37","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1210\/jc.2002-020815","article-title":"Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome","volume":"88","author":"Moran","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B38","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1093\/ajcn\/84.1.77","article-title":"Short-term meal replacements followed by dietary macronutrient restriction enhance weight loss in polycystic ovary syndrome","volume":"84","author":"Moran","year":"2006","journal-title":"Am J Clin Nutr"},{"key":"2025110412213358700_deaf169-B39","doi-asserted-by":"publisher","author":"Mousa","year":"2023","DOI":"10.26180\/23625288.v1"},{"key":"2025110412213358700_deaf169-B40","doi-asserted-by":"publisher","first-page":"102633","DOI":"10.1016\/j.ctim.2020.102633","article-title":"Effect of hypocaloric high-protein, low-carbohydrate diet supplemented with fennel on androgenic and anthropometric indices in overweight and obese women with polycystic ovary syndrome: a randomized placebo-controlled trial","volume":"56","author":"Nadjarzadeh","year":"2021","journal-title":"Complement Ther Med"},{"key":"2025110412213358700_deaf169-B41","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1016\/j.fertnstert.2013.06.030","article-title":"Serum antim\u00fcllerian hormone in response to dietary management and\/or physical exercise in overweight\/obese women with polycystic ovary syndrome: secondary analysis of a randomized controlled trial","volume":"100","author":"Nybacka","year":"2013","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B42","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1016\/j.fertnstert.2011.09.006","article-title":"Randomized comparison of the influence of dietary management and\/or physical exercise on ovarian function and metabolic parameters in overweight women with polycystic ovary syndrome","volume":"96","author":"Nybacka","year":"2011","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B43","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1093\/humrep\/deae017","article-title":"Impact of a hypocaloric dietary intervention on antral follicle dynamics in eumenorrheic women with obesity","volume":"39","author":"Oldfield","year":"2024","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B44","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1007\/s43032-025-01808-8","article-title":"Comparison of metabolic and hormonal profiles between low-advanced glycation end products (AGEs) and standard AGEs-containing weight-loss diets in overweight phenotype-A PCOS patients: a randomized clinical trial","volume":"32","author":"Ozdemir","year":"2025","journal-title":"Reprod Sci"},{"key":"2025110412213358700_deaf169-B45","doi-asserted-by":"publisher","first-page":"2783","DOI":"10.1093\/humrep\/deq254","article-title":"Six weeks of structured exercise training and hypocaloric diet increases the probability of ovulation after clomiphene citrate in overweight and obese patients with polycystic ovary syndrome: a randomized controlled trial","volume":"25","author":"Palomba","year":"2010","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B46","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1093\/humrep\/dem391","article-title":"Structured exercise training programme versus hypocaloric hyperproteic diet in obese polycystic ovary syndrome patients with anovulatory infertility: a 24-week pilot study","volume":"23","author":"Palomba","year":"2008","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B47","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1530\/EJE-10-0692","article-title":"Heterogeneity in the responsiveness to long-term lifestyle intervention and predictability in obese women with polycystic ovary syndrome","volume":"164","author":"Pasquali","year":"2011","journal-title":"Eur J Endocrinol"},{"key":"2025110412213358700_deaf169-B48","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1016\/j.fertnstert.2021.08.018","article-title":"Obesity and reproduction: a committee opinion","volume":"116","author":"Practice Committee of the American Society for Reproductive Medicine","year":"2021","journal-title":"Fertil Steril"},{"key":"2025110412213358700_deaf169-B49","first-page":"1694","article-title":"Dietary intervention versus metformin to improve the reproductive outcome in women with polycystic ovary syndrome. A prospective comparative study","volume":"28","author":"Qublan","year":"2007","journal-title":"Saudi Med J"},{"key":"2025110412213358700_deaf169-B50","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s11695-015-1902-5","article-title":"The impact of bariatric surgery on polycystic ovary syndrome: a systematic review and meta-analysis","volume":"26","author":"Skubleny","year":"2016","journal-title":"Obes Surg"},{"key":"2025110412213358700_deaf169-B51","doi-asserted-by":"publisher","first-page":"4468","DOI":"10.1111\/dom.15801","article-title":"The effects of time-restricted eating alone or in combination with probiotic supplementation in comparison with a calorie-restricted diet on endocrine and metabolic profiles in women with polycystic ovary syndrome: a randomized clinical trial","volume":"26","author":"Talebi","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"2025110412213358700_deaf169-B52","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1093\/humrep\/dead156","article-title":"Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome\u2020","volume":"38","author":"Teede","year":"2023","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B53","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1093\/humrep\/dep101","article-title":"The effect of weight loss on anti-M\u00fcllerian hormone levels in overweight and obese women with polycystic ovary syndrome and reproductive impairment","volume":"24","author":"Thomson","year":"2009","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B54","doi-asserted-by":"publisher","first-page":"3373","DOI":"10.1210\/jc.2008-0751","article-title":"The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome","volume":"93","author":"Thomson","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B55","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1093\/humrep\/deu114","article-title":"Lifestyle intervention up-regulates gene and protein levels of molecules involved in insulin signaling in the endometrium of overweight\/obese women with polycystic ovary syndrome","volume":"29","author":"Ujvari","year":"2014","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B56","doi-asserted-by":"publisher","first-page":"E865","DOI":"10.1152\/ajpendo.00458.2001","article-title":"Increase in daily LH secretion in response to short-term calorie restriction in obese women with PCOS","volume":"282","author":"Van Dam","year":"2002","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B57","doi-asserted-by":"publisher","first-page":"E615","DOI":"10.1152\/ajpendo.00377.2003","article-title":"Retention of estradiol negative feedback relationship to LH predicts ovulation in response to caloric restriction and weight loss in obese patients with polycystic ovary syndrome","volume":"286","author":"Van Dam","year":"2004","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B58","doi-asserted-by":"publisher","first-page":"3666","DOI":"10.1210\/jcem.84.10.6079","article-title":"A critical evaluation of simple methods for the estimation of free testosterone in serum","volume":"84","author":"Vermeulen","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B59","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.2337\/diacare.27.6.1487","article-title":"Use and abuse of HOMA modeling","volume":"27","author":"Wallace","year":"2004","journal-title":"Diabetes Care"},{"key":"2025110412213358700_deaf169-B60","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1093\/humrep\/deae058","article-title":"Resumption of ovulation in anovulatory women with PCOS and obesity is associated with reduction of 11\u03b2-hydroxyandrostenedione concentrations","volume":"39","author":"Wang","year":"2024","journal-title":"Hum Reprod"},{"key":"2025110412213358700_deaf169-B61","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1210\/jcem.81.1.8550768","article-title":"Modulation by insulin of follicle-stimulating hormone and luteinizing hormone actions in human granulosa cells of normal and polycystic ovaries","volume":"81","author":"Willis","year":"1996","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B62","doi-asserted-by":"publisher","first-page":"3984","DOI":"10.1210\/jcem.83.11.5232","article-title":"Premature response to luteinizing hormone of granulosa cells from anovulatory women with polycystic ovary syndrome: relevance to mechanism of anovulation","volume":"83","author":"Willis","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2025110412213358700_deaf169-B63","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1055\/s-0029-1242988","article-title":"Progesterone function in human endometrium: clinical perspectives","volume":"28","author":"Young","year":"2010","journal-title":"Semin Reprod Med"},{"key":"2025110412213358700_deaf169-B64","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1186\/1477-7827-2-31","article-title":"The physiology of follicle selection","volume":"2","author":"Zeleznik","year":"2004","journal-title":"Reprod Biol Endocrinol"},{"key":"2025110412213358700_deaf169-B65","doi-asserted-by":"publisher","first-page":"556","DOI":"10.3390\/nu15030556","article-title":"Effects of a dulaglutide plus calorie-restricted diet versus a calorie-restricted diet on visceral fat and metabolic profiles in women with polycystic ovary syndrome: a randomized controlled trial","volume":"15","author":"Zhang","year":"2023","journal-title":"Nutrients"}],"container-title":["Human Reproduction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/40\/11\/2161\/64237489\/deaf169.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/humrep\/article-pdf\/40\/11\/2161\/64237489\/deaf169.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T17:21:40Z","timestamp":1762276900000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/humrep\/article\/40\/11\/2161\/8250756"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":65,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,9,10]]},"published-print":{"date-parts":[[2025,11,1]]}},"URL":"https:\/\/doi.org\/10.1093\/humrep\/deaf169","relation":{},"ISSN":["0268-1161","1460-2350"],"issn-type":[{"value":"0268-1161","type":"print"},{"value":"1460-2350","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,9,10]]}}}