Al-Azemi Majedah, Omu Florence E, Omu Alexander E
Department of Obstetrics and Gynaecology, Faculty of Medicine, Kuwait University, Kuwait.
Arch Gynecol Obstet. 2004 Dec;270(4):205-10. doi: 10.1007/s00404-003-0537-2. Epub 2003 Aug 29.
Obesity has become a worldwide epidemic with ever increasing incidence and public health problems in both developing and developed countries.
The objective of the study is to investigate the incidence of obesity among patients with polycystic ovarian syndrome attending infertility clinic and the effect on treatment outcome.
Two hundred and seventy women with polycystic ovarian syndrome attending the infertility clinic were evaluated clinically, biochemically, and laparoscopically. They were stratified according to their body mass index (BMI) as follows: normal weight: 18-24; overweight: 25-29, obese:30-34, and grossly obese: > or = 35. Therapy included induction of ovulation with clomiphene citrate and gonadotrophins. The patients were followed up through during induction of ovulation and pregnancy.
There were ethnic differences in mean BMI. Significantly more obese women had oligomenorrhoea (p<0.01) and anovulation (p<0.01) than women with normal weight. Obesity adversely affected the outcome of ovulation induction with clomiphene citrate and gonadotrophins; 79% of women with BMI 18-24 ovulated at 6 months compared to 15.3% in those with BMI 30-34 (p<0.001) and 11.8% in women with BMI > or = 35 (p<0.001). The pregnancy rate and outcome were also adversely affected by obesity.
Obesity has a negative impact on the outcome of treatment of infertility. Weight reduction programme should be an essential component of infertility management.
肥胖已成为一种全球性的流行病，在发展中国家和发达国家的发病率及公共卫生问题都日益增加。
本研究的目的是调查在不孕不育门诊就诊的多囊卵巢综合征患者中肥胖的发生率及其对治疗结局的影响。
对270名在不孕不育门诊就诊的多囊卵巢综合征女性进行了临床、生化和腹腔镜评估。根据她们的体重指数（BMI）进行分层如下：正常体重：18 - 24；超重：25 - 29，肥胖：30 - 34，极度肥胖：≥35。治疗包括使用枸橼酸氯米芬和促性腺激素诱导排卵。在诱导排卵和妊娠期间对患者进行随访。
平均BMI存在种族差异。与正常体重的女性相比，肥胖女性出现月经过少（p<0.01）和无排卵（p<0.01）的情况明显更多。肥胖对枸橼酸氯米芬和促性腺激素诱导排卵的结局产生不利影响；BMI为18 - 24的女性中有79%在6个月时排卵，而BMI为30 - 34的女性中这一比例为15.3%（p<0.001），BMI≥35的女性中为11.8%（p<0.001）。肥胖也对妊娠率和结局产生不利影响。
肥胖对不孕不育治疗的结局有负面影响。减重计划应成为不孕不育管理的重要组成部分。
