A randomized controlled trial comparing lifestyle intervention to letrozole for ovulation in women with polycystic ovary syndrome: a study protocol

Trials. 2018 Nov 16;19(1):632. doi: 10.1186/s13063-018-3009-5.


Background: Polycystic ovary syndrome (PCOS) affects between 8 and 18% of women and is the leading cause of female anovulatory infertility. Unfortunately, common treatments for women trying to conceive can be ineffective as well as disruptive or harmful to patients' quality of life. Despite evidence that women with PCOS have expressed the need for alternative fertility treatments, lifestyle interventions incorporating a nutritional plan with supplementation, increased physical activity, and techniques for stress management have not been combined as a program and studied in this population. Literature suggests that each of these individual components can positively influence reproductive hormones and metabolic health.

Methods/design: This is a randomized controlled trial which will include 240 women diagnosed with PCOS, according to the Rotterdam criteria, who are trying to conceive. Participants will be randomized to either a comprehensive lifestyle intervention program or prescribed an oral fertility medication, letrozole. These two groups will be further randomized to consume either myo-inositol or a placebo. Participants will be between the ages of 18 and 37 years. Exclusion criteria include women who have already begun fertility treatment, who are currently using myo-inositol or have taken it within the past 3 months, or who are being treated for, or have a history of, an eating disorder. The primary outcome will be the ovulation rate, the secondary outcome will be conception. Other outcomes include miscarriage rates, validated rating measures of overall quality of life (including social, relational, mind/body and emotional sub-categories) and mental health scores (depression, anxiety, and stress).

Discussion: This trial will determine the effectiveness of a structured lifestyle-based comprehensive intervention program for women with PCOS experiencing infertility. In addition, it will determine whether supplementing with myo-inositol provides any further benefit. The objective of this study is to assess a possible non-pharmacological solution to ovulatory dysfunction in these patients and perhaps improve other associated features of PCOS.

Trial registration: ClinicalTrials.gov, ID: NCT02630485 . Registered on 15 December 2015.

Keywords: Infertility; Lifestyle; Ovulation; Polycystic ovary syndrome.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Diet, Healthy
  • Exercise
  • Female
  • Fertility Agents, Female / administration & dosage*
  • Fertility Agents, Female / adverse effects
  • Healthy Lifestyle*
  • Humans
  • Infertility, Female / diagnosis
  • Infertility, Female / etiology
  • Infertility, Female / physiopathology
  • Infertility, Female / therapy*
  • Inositol / administration & dosage*
  • Inositol / adverse effects
  • Letrozole / administration & dosage*
  • Letrozole / adverse effects
  • Mindfulness
  • Netherlands
  • Ovulation / drug effects*
  • Patient Education as Topic
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / diagnosis
  • Polycystic Ovary Syndrome / physiopathology
  • Polycystic Ovary Syndrome / therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Randomized Controlled Trials as Topic
  • Relaxation Therapy
  • Time Factors
  • Treatment Outcome
  • Young Adult


  • Fertility Agents, Female
  • Inositol
  • Letrozole

Associated data

  • ClinicalTrials.gov/NCT02630485