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Polycystic ovary syndrome can lead to many life-altering symptoms, but infertility is by far the most heartbreaking. Could eating a big breakfast and reducing calories at dinner improve PCOS patients' fertility and reduce other symptoms?

Could women who suffer from polycystic ovary syndrome (PCOS) improve their fertility and reduce their symptoms by eating a bigger breakfast and a smaller dinner? 

It may sound like a simplistic solution to a complex disorder that is frustrating for patients and doctors alike, but it's exactly what a study team from Tel Aviv, led by Professor Daniela Jakubowicz, is suggesting. If it works, this simple management plan could help many women. 

What's PCOS, Again?

Polycystic overy syndrome is the most common hormonal disorder among women of reproductive age. The syndrome gets its name from the fact that most PCOS patients have many small cysts along the outer edge of their ovaries. 

PCOS comes with many life-altering symptoms, though the exact way in which the disorder manifests itself varies from patient to patient. Irregular menstrual periods, prolonged bleeding, acne, excessive hair growth (including facial hair), and weight gain that sometimes results in obesity are among the symptoms. PCOS can also lead to infertility.

The exact cause of polycystic ovary syndrome is still unknown, but Professor Jakubowicz notes that the majority of patients are insulin resistant.

This means the bodies of these women produce too much insulin, which then goes to the ovaries where it encourages testosterone production. That, in turn, decreases the woman's fertility. 

Early diagnosis of PCOS does reduce the risk of long-term complications like type 2 diabetes and heart disease, and strategies for managing weight and insulin levels are already available. The drug metformin helps many women lose enough weight to improve their insulin levels, enabling them to get pregnant. But there are plenty of PCOS women who are not overweight and still have fertility issues. It is these women that could benefit from the findings of the new Israeli study. 

What Does The Study Say?

The study team separated 60 women with PCOS and a normal Body Mass Index (BMI) into two groups, randomly. The first group was a "big breakfast group". These women consumed a 980-calorie breakfast, a 640-calorie lunch and a then a 190-calorie dinner. The second group was a "big dinner group", in which the calories for breakfast and dinner were arranged in the opposite way: 190 calories for breakfast, 640 calories for lunch and then 980 calories for dinner.

Note that the total intake of calories was the same for both groups at 1,800 calories. After 90 days, both groups were tested for insulin, glucose and testosterone levels and their ovulation and menstruation were analyzed as well. 

The result? While neither group had much of a change in BMI, the big dinner group still showed high insulin and testosterone levels. The big breakfast group, meanwhile, showed a significant improvement with this PCOS diet

They had 56 percent less insulin resistance and their testosterone levels went down by 50 percent! Most interestingly for women with PCOS, the big breakfast group showed a 50 percent improvement in ovulation rates. 

Professor Jakubowicz says that this dietary plan is not a weight-loss plan at all, but rather an insulin-management plan. The women follow a 24-hour metabolic cycle and consume a responsible amount of calories.

The big breakfast, small dinner plan showed promising results in the study participants. It improved their ovulation rates and thus their chances of getting pregnant, but that's not all. The study team says that following this concept also helps prevent type 2 diabetes, and can improve other symptoms associated with PCOS — most notably acne and excess hair growth.

Polycystic ovary syndome decreases overall fertility, but also reduces the odds that fertility treatments are successful, while making the risk of miscarriage if a woman does get pregnant higher. Following the insulin-management plan can help PCOS patients improve their fertility as well as the chance that IVF is successful, while reducing miscarriage odds. Overall, this finding offers much reason for optimism!

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