Impact of Intermittent Fasting on Reproductive Markers in PCOS

Objective: To evaluate the effect of a six-week time-restricted feeding (TRF) regimen on anthropometric, metabolic, and reproductive hormonal parameters in women with polycystic ovary syndrome (PCOS). Study Design and Setting: Retrospective observational study conducted at Medical Teaching Institute Bacha Khan Medical College and Mardan Medical Complex, Mardan Pakistan. Methodology: A total of 63 women diagnosed with PCOS according to Rotterdam criteria who completed a six-week TRF dietary regimen (8-hour feeding window from 1:00 p.m. to 9:00 p.m.) were included. Anthropometric measurements and laboratory parameters were recorded before and after the intervention. Variables assessed included body mass index (BMI), waist-to-hip ratio (WHR), insulin resistance using HOMA-IR, androgen profile (free androgen index, testosterone, SHBG), gonadotropins (LH and FSH), and ovarian reserve markers (estradiol and AMH). Paired t-tests were applied and p < 0.05 was considered statistically significant. Results: Significant reductions were observed in BMI, WHR, HOMA-IR, fasting insulin, and free androgen index. Total and free testosterone levels decreased, while SHBG levels increased significantly. LH levels declined and FSH levels increased, improving the LH/FSH ratio. Estradiol levels increased whereas AMH levels showed a modest decline. Clinical improvement was observed in ovulatory function (60.4%), menstrual regularity (60.9%), and hyperandrogenism (63.6%). TRF showed high adherence (82.5%) with minimal side effects. Conclusion: Time-restricted feeding appears to be a safe and effective lifestyle intervention for improving metabolic and reproductive hormonal parameters in women with PCOS. Further randomized controlled trials with longer follow-up are required.