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Research Article | DOI: https://doi.org/10.31579/2639-4162/285
1Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
2Assistant lecturer of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
3Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Menoufia University, Egypt.
*Corresponding Author: Hanan Elzeblawy Hassan, Bachelor's degree in Health Technology, Physical Therapy and Rehabilitation. Assistant Professor and Research Associate. Sancti Spiritus University of Medical Sciences, Cuba.
Citation: Hanan E. Hassan., Abd-ELhakam FH, Ali Kasem EK, (2025), Relationship between Infertile Overweight and Polycystic Ovary Syndrome Women’s Characteristics and Lifestyle Habits: An Interventional Study, J. General Medicine and Clinical Practice, 8(8); DOI:10.31579/2639-4162/285
Copyright: © 2025, Hanan Elzeblawy Hassan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 18 June 2025 | Accepted: 19 August 2025 | Published: 24 August 2025
Keywords: infertility; overweight; ovary syndrome; women’s characteristics; lifestyle habits
Background: The relationship between obesity and menstrual irregularities, including signs of infertility, was studied using historical data from 26,638 women, aged 20 to 40. Aim: investigate the correlation between infertile overweight and Polycystic Ovary Syndrome women's characteristics and lifestyle habits.
Subjects and Methods:A purposive sample of 116 women with infertility, overweight, and obese with polycystic ovary syndrome who attended to gynecological and infertility outpatient and inpatient clinics at Beni-Suef University Hospital. Using Arabic Structured interviewing questionnaire contains Sociodemographic characteristics, questions about the symptoms of PCOS
Results: It reveals that 77.6% and 56.8% of the study and control groups had menarche at an age of less than 15 years, respectively. 65.5% and 55.2% of the study and control groups had painful menstrual cycles before the intervention, compared to 31% and 55.2% of them after the intervention, respectively.
Conclusion: Significant association between the socio-personal data and total nutrition habit levels among the study group of infertile overweight and obese women with polycystic ovary syndrome and association between the ovulatory function and physical activity level in the study group of infertile overweight and obese women with polycystic ovary syndrome were found Recommendations: A study can be conducted to assess the knowledge, attitude and practice on women with PCOS regarding weight reduction exercises
One of the most prevalent factors contributing to female anovulatory infertility is polycystic ovarian syndrome (PCOS). Obesity, which affects almost half of PCOS women, worsens infertility by hurting menstruation, ovulation, pregnancy rates, and live birth rates [1-6]. According to The Medical Journal of Australia, a startling 12% to 21% of Australian women of reproductive age are affected by PCOS, with the condition being more prevalent in people who are overweight or of indigenous ancestry. 70% of Australian women with PCOS are thought to still be undiagnosed [7-10]. Around the world, obesity has emerged as a serious health issue. One-fifth of women in the UK suffer from obesity, with 18.3% of women in the reproductive age range (16-44 years) being classified as obese [11-14]. It is well-known that many PCOS patients are overweight, but not all of them. Since adipose tissue is regarded to be an endocrine organ that produces androgens, there is growing evidence that PCOS in some women develops as a result of obesity [15-20]. A higher risk of infertility is linked to oligo anovulation, and PCOS is the most common cause of ovulatory problems. Primary infertility was observed in 50% of cases and secondary infertility in 25% of instances in a large group of 1,741 women with PCOS [21-26].
The relationship between obesity and menstrual irregularities, including signs of infertility, was studied using historical data from 26,638 women, aged 20 to 40. After accounting for height and age, it was discovered that women with indications of anovulatory periods-otherwise known as irregular cycles lasting longer than 36 days and hirsutism-were more than 30 lb (13.6 kg) heavier than those without menstrual abnormalities [7]. Obesity and infertility have a complex relationship. The knowledge that is now available supports the idea that androgen changes and their interaction with estrogen are the primary mechanism causing subfertility or infertility in obese women [27-30]. Additionally, gaining weight induces insulin resistance, which raises insulin levels and decreases the liver's ability to synthesize SHBG, both of which increase the amount of bioavailable testosterone as previously mentioned. Furthermore, the PCOS phenotype is eliminated in the majority of adult women who have bariatric surgery or significant weight loss by lifestyle adjustments. This might make obesity a contributing factor to anovulation and hyperandrogenemia in some PCOS women [31]. Based on the minutes from the meeting, PCOS should be classified when two out of the following three characteristics are present: oligo- or anovulation, clinical or biochemical indicators of hyperandrogenism, and PCOM are the first three symptoms [32]. Polycystic ovary syndrome, determined by transvaginal ultrasonography, was defined as the existence of at least one ovary with 12 or more follicles measuring 2-9 mm in diameter, independent of location, and/or a total volume > 10 mL3 [33].
This study aims to investigate the relationship between infertile overweight and polycystic ovary syndrome women’s characteristics and lifestyle habits
A purposive sample of 116 women with infertility, overweight, and obese with polycystic ovary syndrome who attended to gynecological and infertility outpatient and inpatient clinics at Beni-Suef University Hospital. Using Arabic Structured interviewing questionnaire contains Sociodemographic characteristics, questions about the symptoms of PCOS
Data were collected, tabulated, and statistically analyzed using an IBM personal computer with Statistical Package of Social Science (SPSS) version 25 (SPSS, Inc, Chicago, Illinois, USA), where the following statistics were applied: Descriptive statistics: in which quantitative data were presented in the form of mean (X), standard deviation (SD), and qualitative data were presented in the form of numbers and percentages. Analytical statistics: used to find out the possible association between the study factors and the targeted variables.
Figure 1 shows the ovulatory function and features of oligo or anovulation in the studied infertile overweight and obese women with polycystic ovary syndrome. It reveals that 77.6% and 56.8% of the study and control groups had menarche at an age of less than 15 years, respectively. Also, 58.6% of the study and control groups had a 3–5-day duration of the menstrual cycle before the intervention, compared to 86.2% and 55.2
The findings of the current study revealed that the mean age in the study and control groups was 28.7±2.87 and 28.8±3.00 before and after the intervention, respectively. This finding came in agreement with Amirjani, et al., (2019), who studied the “Dietary intake and lifestyle behavior in different phenotypes of polycystic ovarian syndrome”, which concluded that the mean age of the studied patients with infertile, overweight, and obese women with polycystic ovary syndrome is (29.03 ±3.31) (29.85 ±6.40) [34]. From the researcher's point of view; these results may be justified that PCOS is a very common endocrine disorder among women of reproductive age. This finding was incongruent with Che, et al., 2021, who studied the “Lifestyle intervention for overweight/obese women with polycystic ovarian syndrome. They revealed that the mean age of the study participants was 31.79±3.38, and 32.31±3.79 [35]. According to the researcher's point of view, this discrimination in mean age between the current study and those previous studies could be attributed to differences in settings. Previous studies were conducted in urban areas. Meanwhile, these findings were incongruent with those of Al Anwar, et al., (2022), who concluded that most of the studied participants were secondary and primary education and rural residents. This incongruence between the current and previous studies may be related to patients living in rural areas; they usually prefer to have secondary education and to get married at an early age [36].
The current study findings revealed that most patients in both the study and control groups had ages of menarche before 15 years. Also, in line with the present findings; from the researcher's point of view, many studies have pointed to verified that a slightly later onset age (15 to 18 years) at menarche could reduce the risk of PCOS. These findings came in agreement with researchers, who studied "Age at menarche and polycystic ovary syndrome” and [37-38]. They revealed that the age of menarche is between 10-18 years. Menarche is one of the major causes of PCOD/PCOS due to poor diagnosis of normal pubertal ovaries and polycystic ovaries. The current results were not in the same line with Desai, et al., (2018), and Thathapudi, et al., (2014), (Indian study) who showed that the mean ages of menarche were over 14 years in PCOS girls, respectively [39-40]
Regarding the duration of the menstrual cycle, the findings of the current study showed that the present study revealed that, there were highly statistically significant improvements in menstrual cycle irregularities in the study, more than half of the study and control groups had a 3–5-day duration of the menstrual cycle before the intervention compared to the majority of the study group had had a 3-5 day duration of the menstrual cycle after the intervention. These findings are similar to the study done by Öberg, (2022). They studied "Effects of Lifestyle Intervention in Overweight Women with Polycystic Ovary Syndrome. From the researcher's point of view, lifestyle interventions have been shown to have positive effects in terms of improved menstrual cycle irregularities [41].
In addition, the current study findings revealed that more than three-quarters of the study and control group had irregular cycles before the intervention, while more than two-thirds of the study group had regular cycles after the intervention. These findings came in agreement with Marzouk, et al., )2016(. They studied the “Effect of dietary weight loss on menstrual regularity in obese young adult women with polycystic ovary syndrome.” They revealed that the Dietary weight loss in adolescent women with PCOS resulted in significant improvement in menstrual regularity [42]. From the researcher's point of view, lifestyle interventions have been shown to have positive effects in terms of improved ovulation function. The current study findings revealed that there is an association between the Socio-personal data and their total nutrition habits levels among the study group of infertile overweight and obese women with polycystic ovary syndrome. In which lower educated women, rural residents had poor lifestyle habits and less compliance to live lifestyle modification program. These results came in agreement with Tay, et al., (2023), who studied “High prevalence of medical conditions and unhealthy lifestyle behaviors in women with PCOS during preconception, and found out that better-educated women may be more proactive in healthcare engagement and adopt healthier lifestyle choices [43]. According to the researcher’s point of view, this may be justified as educated women getting more information sources about their condition through the internet or media than illiterate women. Also, the educational level can highly affect patients ‘perception of their condition, thus influencing the level of early detection, diagnosis, and treatment.
The current study findings revealed that there is an association between ovulatory function improvement and lifestyle habits in the study group of infertile overweight and obese women with polycystic ovary syndrome. This was in line with a meta-analysis carried out by Abdolahian et al., (2020), to evaluate the impact of lifestyle changes on the anthropometric, clinical, and biochemical parameters in adolescent girls with PCOS following three to twelve months of intervention. The program also showed improvement in menstrual cycle irregularities [44]. In another investigation carried out in Stockholm, Sweden's Karolinska University Hospital, Dietary control, and exercise, either alone or in combination, are equally helpful in improving ovarian function in women with PCOS, according to a study that compared the effects of three months of these three interventions on ovarian function in PCOS-affected women [45].
Significant association between the socio-personal data and total nutrition habit levels among the study group of infertile overweight and obese women with polycystic ovary syndrome and association between the ovulatory function and physical activity level in the study group of infertile overweight and obese women with polycystic ovary syndrome were found
Recommendations:
A study can be conducted to assess the knowledge, attitude and practice on women with PCOS regarding weight reduction exercises.
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Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.
