Balen Adam H, Anderson Richard A
Reproductive Medicine & Surgery, Leeds Teaching Hospitals, Leeds, UK.
Hum Fertil (Camb). 2007 Dec;10(4):195-206. doi: 10.1080/14647270701731290.
Obesity has a significant adverse impact on reproductive outcome. It influences not only the chance of conception but also the response to fertility treatment, and increases the risk of miscarriage, congenital anomalies and pregnancy complications in addition to potential adverse effects on long term health of both mother and infant. Women should aim for a normal BMI before starting any form of fertility treatment. Treatment should be deferred until the BMI is less than 35 kg/m2, although in those with more time (e.g., less than 37 years; normal serum FSH concentration) a weight reduction to a BMI of less than 30 kg/m2 is preferable. Clinicians should consider deferring treatment to women outside these guidelines. Women should be provided with assistance to lose weight, including psychological support, dietary advice, exercise classes and where appropriate, weight reducing agents or bariatric surgery. Even a moderate weight loss of 5-10% of body weight can be sufficient to restore fertility and improve metabolic markers.
肥胖对生殖结局有显著的不利影响。它不仅影响受孕几率，还影响对生育治疗的反应，并增加流产、先天性异常和妊娠并发症的风险，此外还可能对母婴的长期健康产生不利影响。女性在开始任何形式的生育治疗前应将体重指数（BMI）控制在正常范围。治疗应推迟到BMI低于35kg/m²，不过对于有更多时间的女性（如年龄小于37岁；血清促卵泡生成素浓度正常），将体重减至BMI低于30kg/m²更佳。临床医生应考虑对超出这些指导原则的女性推迟治疗。应向女性提供减肥帮助，包括心理支持、饮食建议、健身课程，以及在适当情况下使用减肥药物或进行减肥手术。即使体重适度减轻5%-10%也足以恢复生育能力并改善代谢指标。
