INTRODUCTION: Female obesity and infertility are frequently linked to polycystic ovarian syndrome (PCOS), which has major consequences for metabolism and reproductive health. This study was designed to explore the effect of adding ultrasound cavitation (UC) to aerobic exercises on menstrual regularity, gonadotropin hormones, infertility-related stress, and cortisol levels in obese PCOS women. MATERIAL AND METHODS: Sixty obese women diagnosed with PCOS, age 20 to 35, were randomly distributed into control group A (n = 30) and cavitation group B (n = 30). All cases in both groups received moderate-intensity aerobic training for 50 minutes, five times weekly for 12 weeks. The cavitation group also received UC on the abdomen once a week. Body mass index (BMI), waist-hip ratio (WHR), menstrual regularity, gonadotropin hormones, viz. luteinizing hormone (LH), follicle-stimulating hormone (FSH), and LH/FSH ratio, infertility-related stress and cortisol levels were assessed pre-intervention and after 12 weeks. RESULTS: Significant improvements post-treatment versus pre-treatment were noted within both groups in all outcome variables (BMI, WHR, LH, LH/FSH ratio, infertility-related stress, and cortisol) (p < 0.05). However, the cavitation group demonstrated more significant reduction improvements in BMI, WHR, LH, LH/FSH ratio, infertility-related stress, and cortisol levels compared to the control group post-treatment (p < 0.05). CONCLUSIONS: Adding UC to aerobic exercises should be suggested as an effective intervention for improving BMI, WHR, LH, LH/FSH ratio, infertility-related stress, and cortisol levels in PCOS women.

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