Department of Obstetrics and Gynaecology, Meander Medical Centre, Ringweg Randenbroek 110, Amersfoort, The Netherlands.
Hum Reprod Update. 2010 May-Jun;16(3):246-54. doi: 10.1093/humupd/dmp053. Epub 2010 Jan 7.
Overweight and obesity are an epidemic in Western society, and have a strong impact on fertility. We studied the consequences of overweight and obesity with respect to fecundity, costs of fertility treatment and pregnancy outcome in subfertile women.
We searched the literature for systematic reviews and large studies reporting on the effect of weight on both fecundity and pregnancy outcome in subfertile women. We collected data on costs of treatment with ovulation induction, intrauterine insemination and in vitro fertilization, as well as costs of pregnancy complications. We calculated, for ovulatory and anovulatory women separately, the number of expected pregnancies, complications and costs in a hypothetical cohort of 1000 normal weight, overweight and obese women each.
In our hypothetical cohort of 1000 women, compared with women with normal weight, live birth was decreased by 14 and 15% (from 806 live births to 692 and 687 live births) in overweight and obese anovulatory women, respectively, for ovulatory women it was decreased by 22 and 24% (from 698 live births to 546 and 531 live births), respectively. These outcomes were associated with an increase in the number of complications and associated costs leading to cost per live birth in anovulatory overweight and obese women were 54 and 100% higher than their normal weight counterparts, for ovulatory women they were 44 and 70% higher, respectively.
Overweight and obese subfertile women have a reduced probability of successful fertility treatment and their pregnancies are associated with more complications and higher costs.
超重和肥胖是西方社会的一种流行病，对生育能力有很大影响。我们研究了超重和肥胖对生育能力、生育治疗成本和妊娠结局的影响。
我们检索了文献中的系统评价和大型研究，这些研究报告了体重对不孕妇女的生育能力和妊娠结局的影响。我们收集了排卵诱导、宫腔内人工授精和体外受精治疗成本以及妊娠并发症成本的数据。我们分别计算了排卵性和无排卵性肥胖妇女中，1000 名正常体重、超重和肥胖妇女的预期妊娠、并发症和成本。
在我们的 1000 名女性假设队列中，与体重正常的女性相比，超重和肥胖的无排卵性女性的活产率分别降低了 14%和 15%（从 806 例活产下降到 692 例和 687 例），而排卵性女性的活产率则分别降低了 22%和 24%（从 698 例活产下降到 546 例和 531 例）。这些结果与并发症数量的增加和相关成本的增加有关，导致无排卵性超重和肥胖妇女的每例活产成本比正常体重妇女高出 54%和 100%，而排卵性妇女的成本则高出 44%和 70%。
超重和肥胖的不孕妇女成功进行生育治疗的可能性降低，她们的妊娠并发症更多，成本更高。
