Virginia Via Research Day Book 2026

Medical Student Research Clinical

INTEGRATIVE NON-PHARMACOLOGIC MANAGEMENT OF POLYCYSTIC OVARY SYNDROME: A LITERATURE REVIEW OF KETOGENIC DIET AND OSTEOPATHIC MANIPULATIVE TREATMENT ON REPRODUCTIVE OUTCOMES

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Michella Donfack, OMS III; Angela Simpson, OMS III; James Mahaney, PhD Corresponding author: mdonfack@vcom.eduu

VCOM-Virginia, Blacksburg, Virginia

Background: Between eight and thirteen percent of women of reproductive age are affected by polycystic ovarian syndrome (PCOS), a leading cause of infertility. Traditionally, it is treated with medication and weight management, but many women continue to struggle with hormonal imbalance and ovarian issues related to this condition. Recently, non-drug therapies have shown improvements in both metabolic and reproductive health. The ketogenic diet (KD) and Osteopathic Manipulative Therapy (OMT) are increasingly gaining attention as complementary options for improving both metabolic and reproductive outcomes. Objective: This literature review aimed to synthesize evidence on the effect of KD and OMT on ovulation and fertility outcomes, as well as the associated reproductive hormone profiles in women with PCOS. Methods: A comprehensive search on PubMed and Google Scholar identified human studies published between 2015 and 2025. The eligible studies included women of reproductive age with PCOS or infertility who followed a KD or very low-carbohydrate diet under 50 grams per day or received OMT. The studies’

outcomes had to report at least one reproductive result, such as pregnancy, Anti-Mullerian Hormone (AMH), Sex Hormone Binding Globulin (SHBG), Luteinizing Hormone (LH), or Follicular Stimulating Hormone (FSH). After applying the inclusion criteria and screening, 15 studies were analyzed in total (12 with KD and 3 with OMT). Results: Studies involving patients following the Ketogenic diet showed decreased total and free testosterone, increased SHBG, and normalization of the LH: FSH ratio, all indicating improved hormonal balance. Several studies also reported restored ovulation and successful pregnancies. The OMT studies demonstrated improved menstrual regularity, reduced menstrual distress, and enhanced pelvic perfusion on Doppler imaging. Both interventions were associated with favorable endocrine reproductive function and were well-tolerated. Conclusion: OMT and KD are shown to address the complementary aspects of PCOS through metabolic, hormonal, and structural autonomic mechanisms.

Together, they may provide a holistic, patient-centered approach to improving fertility outcomes in women with PCOS. Larger standardized studies are needed to confirm these promising results and establish the long term benefits. Ethical Approval: This study is a literature review and did not involve human or animal subjects.

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189 2026 Research Recognition Day