Veerle De Frène is holder of a Special PhD Fellowship by the Flemish Foundation for Scientific Research (FWO-Vlaanderen). Petra De Sutter is holder of a fundamental clinical research mandate by the Flemish Foundation for Scientific Research (FWO-Vlaanderen). There are no competing interests.

The high use of health care resources in COPD patients in the final months of life suggests a focus on prolonging life and a tendency toward aggressive care. Limiting potentially inappropriate care and improving the quality of end-of-life care in advanced COPD are, therefore, important public health challenges.

Objective To evaluate changes in body mass index (BMI) and health‐related quality of life (HRQoL), including an acne parameter, of overweight adult women with polycystic ovary syndrome (PCOS) during a lifestyle modification program. Design Prospective longitudinal within‐patient study. Setting Department of Reproductive Medicine of the Ghent University Hospital (Belgium). Participants Thirty‐three overweight (BMI ≥ 25 kg/m²) women with PCOS between age 18 and 43 years. Methods Participants followed a 24‐week lifestyle modification program consisting of a diet, exercise, and psychological subprogram. BMI was assessed at Weeks 0, 8, 16, and 24 of the program. The HRQoL was measured at Week 0, 12, and 24 of the program using the PolyCystic Ovary Syndrome Questionnaire (PCOSQ) and a Visual Analogue Scale (VAS) to evaluate the influence of acne on HRQoL. Results During a 24‐week period no significant decrease in BMI occurred (mean difference = 1.71, 95% confidence interval [CI] [−1.38, 4.81]. During that period, there was a significant positive evolution of the total PCOSQ score, F(2, 37.5) = 23.7, the emotions, F(2, 37.9) = 4.2, weight, F(2, 42.1) = 24.8, body hair, F(2, 35.6) = 3.3, and infertility problems domain scores, F(2, 43.1) = 15.64, of the PCOSQ, as well as of the acne VAS score, F(2, 29.3) = 4.2. These effects primarily occurred during the first 12 weeks. Conclusion In spite of no significant changes in BMI, the HRQoL of overweight adult women with PCOS significantly improved during a 24‐week lifestyle modification program.

V.D.F. is holder of a Special PhD Fellowship of the Flemish Foundation for Scientific Research (FWO-Vlaanderen). P.D.S. is holder of a fundamental clinical research mandate of the Flemish Foundation for Scientific Research (FWO-Vlaanderen). This research also received financial support by Merck Serono and Artevelde University College Ghent. There are no competing interests.

Background: Gonadotropin therapy and laparoscopic ovarian drilling (LOD) are treatment options for ovulation induction (OI) in clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients. The current evidence of the cost-effectiveness of both treatments is scarce, conflicting and performed from different health-economic perspectives. Methods: A retrospective health-economic evaluation was performed from a societal perspective in which human menopausal gonadotropin (hMG) therapy (n = 43) was compared with LOD (n = 35), followed by OI with CC and/or hMG if spontaneous ovulation did not occur within 2 months. Data were collected until the patients were pregnant, with a time limit of 6 months after the onset of treatment. Outcomes were expressed as ongoing pregnancy rate and number of live-born children. Results: The ongoing pregnancy rate was 21/35 (60%) after LOD and 30/43 (69.8%) after hMG treatment (relative risk 0.85, 95% CI 0.61-1.19). The societal cost per patient, up to an ongoing pregnancy, was significantly higher after LOD versus hMG treatment (adjusted mean difference EUR 1,073, 95% CI 180-1,967). Conclusion: This economic evaluation based on real-life data shows that the societal cost up to an ongoing pregnancy is less after hMG treatment when compared with LOD surgery in CC-resistant PCOS patients.