Polycystic Ovary Syndrome and Exercise

The ovulation rate is defined as the number of times a participant ovulates during the intervention period adjusted for the baseline ovulation rate during the run-in phase.

This will be assessed using the Ferriman-Gallwey Score, which quantifies hair growth in women with PCOS. Scores range from 0-36, with higher scores indicating more hair growth.

The menstrual cycle starts on the first day of menses and lasts until menses resumes. A regular menstrual cycle length ranges from 24 to 35 days.

The luteal phase length is defined as the number of days from ovulation to menses (normal is 12 to 16 days).

Pregnancy will be confirmed by the presence of a fetal heart beat on a first-trimester ultrasound, ordered by the participant's physician.

Non-induced embryonic or fetal death or passage of products of conception before 20 weeks gestation.

The delivery of a live infant

Change in body weight pre- and post-intervention

Change in body mass index pre- and post-intervention

Change in waist circumference pre- and post-intervention

Change in blood pressure pre- and post-intervention

Change in hemoglobin A1c pre- and post-intervention

Change in fasting glucose pre- and post-intervention

Change in fasting insulin pre- and post-intervention

Change in HOMA-IR pre- and post-intervention

To assess insulin resistance using the updated HOMA-2 model

Change in lipid profile pre- and post-intervention

Change in liver enzymes pre- and post-intervention

Change in cardiorespiratory fitness assessed as maximal oxygen consumption evaluated using a treadmill test and a metabolic cart

Change in Health-Related Quality of Life using the PCOS-Q and SF-36

Change in symptoms of obstructive sleep apnea pre- and post-intervention using the STOP-BANG score. This score has 8 questions, and the likelihood of obstructive sleep apnea increases with a score of 3 or more.

To assess participant satisfaction with their participation in this study using a questionnaire specifically designed for this study, with higher numbers indicating higher satisfaction.

Participant recruitment will be assessed by recording the number of participants that were initially screened.

The investigators will document how each participant was recruited (i.e. poster, physician referral, etc.).

The investigators will record the number that met all inclusion and exclusion criteria.

The investigators will record the number that agreed to participate in the study and signed informed consent.

Dropout will be reported as a percentage of participants that enrolled in the study and did not complete the study.

Participants will record features of their menstrual cycle daily (menses, spotting, no menstrual bleeding) using a monthly calendar, or phone app. Adherence will be recorded as the percentage of data recorded over the study duration.

Participants will complete the OPK test daily, take a digital photograph of the used test strip and send it to the research team daily. Adherence will be recorded as the percentage completed over the study.

For individuals randomized to the high-intensity training group or the continuous aerobic exercise training group, exercise sessions will be tracked using a Polar heart rate monitor and data will be downloaded weekly at a supervised exercise session. Participants will also log their workouts (type, duration, intensity) in a log book.

Pre- and post-intervention stool samples will be assessed with 16S rRNA sequencing.

All individuals will wear Polar A370 fitness trackers during the intervention phase, and daily steps and kilocalories per day will be recorded.

Individuals randomized to the exercise groups will complete the Physical Activity Enjoyment Scale during an exercise training session at the beginning of the exercise intervention, at 3 months into the intervention and at 6 months into the intervention.