Long-term follow-up of PCOS-patients – the LIPCOS Trial

Objective: In the LIPCOS (Lifestyle Interventions in PCOS) -Trial long – term changes of PCOS-related symptoms were studied in oligomenorrhoeic women and differentiated by occurrence of pregnancy and lifestyle changes during the preceding years.

Patients and methods: Intra-individual change of cycle length, hyperandrogenemia, BMI and lifestyle changes were compared in 25 mothers and 39 childless women with PCOS. Study examinations comprised a detailed hormonal profile, ultrasound classification of the ovaries (according to F. Geisthövel et al.³) and 3-hour measurements of glucose, c-peptide and insulin secretion after a standardized test meal.

Results: Over the preceding 10 years, cycle length had shortened in all women (Ø 33,6yrs, n = 64) from 53,5 to 48,7 days (n = 61). 44% (n = 11) of mothers (n = 25, Ø 38,2yrs, BMI 22,7) reported a shortening of cycle length (56,6 to 49,3 days), but only 28,2% (n = 11) of childless women (n = 39, Ø 30,6yrs, BMI 22,9; 52,1 to 48,3 days). Present TT levels were lower (67,6 vs. 79,96% of upper norm-limit) and acne and alopecia were milder (16 and 28% vs. 48,7 and 72%) in mothers than in childless patients. Ovarian score was lower in mothers (right: 0,7 vs. 1,5; p = 0,004, left: 0,9 vs. 1,3; n.s.). Mothers reported a healthier nutrition and a more regular everyday life compared to childless patients (88 and 92% vs. 69,2% and 61,5%).

Basal and postprandial insulin levels were similar in PCOS-patients and weight-matched controls (C). However, glucose levels at baseline were significantly elevated in PCOS-patients (92,88 ± 10,28 (PCOS) vs. 85,07 ± 9,42 mg/dl (C); p < 0.001), while postprandial glucose levels were not different

Conclusion: Long-term intra-individual change of cycle length and features of PCOS apear to correlate with motherhood.

³Human Reproduction (2005), 20, Sup. 1, P-382