Department of Internal Medicine, Yale-New Haven Hospital, St. Raphael Campus, New Haven, CT, USA.
Faculty of Medical Sciences, University of The West Indies, St Augustine, Trinidad, W.I., Trinidad and Tobago.
Best Pract Res Clin Obstet Gynaecol. 2015 May;29(4):565-76. doi: 10.1016/j.bpobgyn.2014.12.003. Epub 2014 Dec 24.
Obesity is a known risk factor for infertility in women. The exact mechanism through which obesity is linked to infertility is still not fully understood. Hyperleptinaemia, hyperinsulinaemia and resultant hyperandrogenism are all thought to play a role. Various medical and surgical interventions have been attempted to improve fertility rates in obese women. Encouraging evidence for pharmacotherapy, bariatric surgery and assisted reproduction are yet to be seen. In this chapter, we review the hormonal changes in obesity and the evidence behind medical and surgical interventions to improve fertility in obese women.
肥胖是女性不孕的已知危险因素。肥胖与不孕之间的确切联系机制仍不完全清楚。高瘦素血症、高胰岛素血症和由此导致的高雄激素血症都被认为起作用。已经尝试了各种医疗和手术干预措施来提高肥胖女性的生育能力。药物治疗、减肥手术和辅助生殖的令人鼓舞的证据仍有待观察。在本章中，我们回顾了肥胖症的激素变化以及改善肥胖女性生育能力的医疗和手术干预的证据。
