Impact of male and female weight, smoking, and intercourse frequency on live birth in women with polycystic ovary syndrome

Alex J. Polotsky, Amanda A. Allshouse, Peter R. Casson, Christos Coutifaris, Michael P. Diamond, Gregory M. Christman, William D. Schlaff, Ruben Alvero, J. C. Trussell, Stephen A. Krawetz, Nanette Santoro, Esther Eisenberg, Heping Zhang, Richard S. Legro

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Context: Obese men with normal semen parameters exhibit reduced fertility but few prospective data are available. Objective: This study aimed to determine the effect of male factors and body mass among the Pregnancy in Polycystic Ovary Syndrome II (PPCOS II) participants. Methods: This is a secondary analysis of the PPCOS II trial. A total of 750 infertile women with polycystic ovary syndrome (PCOS) were randomly assigned to up to receive five cycles of letrozole or clomiphene citrate. Females were 18-39-years-old and had a male partner with sperm concentration of at least 14 million/mL who consented to regular intercourse. Analysis was limited to couples with complete male partner information (n = 710). Results: Male body mass index(BMI)was higher in couples who failed to conceive(29.5 kg/m2 vs 28.2 kg/m2; P = .039) as well as those who did not achieve a live birth (29.5 kg/m2 vs 28.1 kg/m2; P = .047). At least one partner was obese in 548 couples (77.1%). A total of 261 couples were concordant for obesity (36.8%). After adjustment for female BMI, the association of male BMI with live birth was no longer significant (odds ratio [OR] = 0.85; 95% confidence interval [CI], 0.68-1.05; P = .13). Couples in which both partners smoked had a lower chance of live birth vs nonsmokers (OR = 0.20; 95% CI, 0.08-0.52; P = .02), whereas there was not a significant effect of female or male smoking alone. Live birth was more likely in couples with at least three sexual intercourse attempts over the previous 4 weeks (reported at baseline) as opposed to couples with lesser frequency (OR = 4.39; 95% CI, 1.52-12.4; P < .01). Conclusions: In this large cohort of obese women with PCOS, effect of male obesity was explained by female BMI. Lower chance of success was seen among couples where both partners smoked. Obesity and smoking are common among women with PCOS and their partners and contribute to a decrease in fertility treatment success.

Original languageEnglish (US)
Pages (from-to)2405-2412
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Issue number6
StatePublished - Jun 1 2015

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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