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IntroductionPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age and the leading cause of anovulatory infertility. Women with PCOS have a 15-fold higher prevalence of infertility, compared with women without PCOS, independent of body mass index (BMI). A healthy lifestyle is recommended to improve overall health and fertility in PCOS but there is limited evidence on the isolated effects of exercise, especially for reproductive outcomes. Previous findings indicate superior metabolic health benefits after vigorous compared with moderate-intensity exercise. Our primary aim is to determine the effect of high-intensity interval training (HIT) on menstrual frequency, as a proxy of reproductive function, in women with PCOS.Methods and analysisThe study is a two-centre, randomised, controlled trial with three parallel groups. Women (n=64) from Trondheim (Norway) and Melbourne (Australia) with PCOS according to the Rotterdam criteria will be randomly allocated (1:1:1) to high-volume HIT, low-volume HIT or a control group with no exercise after stratifying for BMI < or ≥ 27 kg/m2 and study centre. Measurements for study end points will be undertaken at baseline, after a 16 week exercise intervention and at 12 months following baseline assessments. The primary outcome measure is menstruation frequency, measured as the number of self-reported menstrual bleedings divided by the number of expected menstrual bleedings during a 12-month period. Secondary outcome measurements include markers of cardiovascular, metabolic and reproductive health, as well as quality of life and adherence to and enjoyment of exercise.Ethics and disseminationThe Regional Committee Medical Research Ethics, Norway, and The Australian Catholic University Human Research Ethics Committee, Australia, have approved the trial protocol. This trial will provide new insight regarding the impact of exercise on fertility in PCOS. We expect this trial to contribute to new therapeutic exercise strategies as part of clinical care for women with PCOS.Trial registration numberClinical trial gov NCT02419482.

Purpose To investigate the variability of the normal-sized fetal renal pelvis (≤5 mm) over time and to analyze repeatability of measurements. Materials and Methods 98 fetal renal pelvises and 49 fetal urinary bladders were analyzed at a gestational age of 17–20 weeks at St. Olavs Hospital, Trondheim, Norway. The anterior-posterior diameter (APD) of the fetal renal pelvis and two diameters of the fetal bladder were measured with an interval of at least 30 min. Intra- and interobserver variations and variations over time and in association with bladder size were investigated. Results The mean difference in renal pelvis size between the first and second measurements was 0.09 mm (95% CI, −0.09 to 0.26 mm). The variation over time was ≤1 mm in 85% of cases and the renal pelvis was ≤4 mm in both the first and second examinations in 92% of cases. The intraclass correlation coefficient (ICC) was 0.54 (95% CI: 0.31 to 0.69). We did not observe any association between variation of bladder size and variation of APD. The difference in fetal renal pelvis size was ≤1 mm in 70% of observations for the first examiner and 58% for the second examiner. The intraobserver ICCs were 0.71 (95% CI: 0.62–0.78) and 0.60 (95% CI: 0.50–0.70) for the two observers respectively. The interobserver difference was ≤1 mm in 72% of cases and the interobserver ICC was 0.56 (95% CI: 0.34–0.71). Conclusion The variation of the APD of the fetal renal pelvis over time was small in fetuses with the APD in the lower range and can mainly be explained by intraobserver variation.