Bellver José, Busso Cristiano, Pellicer Antonio, Remohí José, Simón Carlos
Instituto Valenciano de Infertilidad, University of Valencia, Spain.
Reprod Biomed Online. 2006 May;12(5):562-8. doi: 10.1016/s1472-6483(10)61181-9.
Obesity is a rising health problem in Western societies. It has been related to increased morbidity and mortality rates due to several pathologies. In the field of gynaecology and reproduction, obesity is associated with menstrual disorders, hirsutism, infertility, miscarriage and obstetric complications. It is known to impair human reproduction through different mechanisms such as insulin resistance, hyperandrogenism and elevated leptin levels. Weight management and dietary intervention can reverse this situation and improve reproductive function. Obesity can also impair the outcome of assisted reproductive technologies. The lower probability of a healthy live birth described in obese women seems to be the result of a combination of lower implantation and pregnancy rates, higher preclinical and clinical miscarriage rates and increased complications during pregnancy for both mother and fetus. Studies performed in infertile women undergoing assisted reproduction technologies indicate that the ovary plays a leading, but not exclusive, role in the fertility prognosis of these patients. The endocrine and metabolic environment may affect oocyte quality and, therefore, embryo development, implantation and pregnancy outcome. The endometrium seems to play a subtle role in the more negative reproductive outcome of obese women, according to recent studies based on the ovum donation model.
肥胖在西方社会是一个日益严重的健康问题。由于多种病症，它与发病率和死亡率的上升有关。在妇科和生殖领域，肥胖与月经紊乱、多毛症、不孕、流产及产科并发症相关。已知它通过胰岛素抵抗、高雄激素血症和瘦素水平升高等不同机制损害人类生殖。体重管理和饮食干预可以扭转这种情况并改善生殖功能。肥胖还会损害辅助生殖技术的结局。肥胖女性健康活产概率较低似乎是着床率和妊娠率较低、临床前和临床流产率较高以及母亲和胎儿孕期并发症增加共同作用的结果。对接受辅助生殖技术的不孕女性进行的研究表明，卵巢在这些患者的生育预后中起主要但非唯一作用。内分泌和代谢环境可能影响卵母细胞质量，进而影响胚胎发育、着床和妊娠结局。根据最近基于卵子捐赠模型的研究，子宫内膜似乎在肥胖女性更负面的生殖结局中起微妙作用。
