Tziomalos Konstantinos, Dinas Konstantinos
First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
Second Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
Front Endocrinol (Lausanne). 2018 Apr 4;9:149. doi: 10.3389/fendo.2018.00149. eCollection 2018.
Assisted reproduction, including fertilization and intracytoplasmic sperm injection, is increasingly being used for the management of infertility in patients with polycystic ovary syndrome (PCOS). However, there are limited data regarding the association between obesity and the outcome of assisted reproduction in this specific population as well as on the effects of weight loss. The aim of the present review is to summarize the existing evidence on the association between obesity and the outcome of assisted reproduction in patients with PCOS. Accumulating data suggest that obesity is associated with lower pregnancy and live birth rates in patients with PCOS who are undergoing assisted reproduction therapy. However, it remains unclear whether weight loss improves the outcome of this therapy. Notably, recent guidelines state that the health benefits of postponing pregnancy to achieve weight loss must be balanced against the risk of declining fertility with advancing age. Therefore, if weight loss is not achieved within a reasonable time period, assisted reproduction therapy should be offered in adequately selected patients with PCOS, regardless of the presence of obesity.
辅助生殖,包括体外受精和卵胞浆内单精子注射,越来越多地用于治疗多囊卵巢综合征(PCOS)患者的不孕症。然而,关于肥胖与这一特定人群辅助生殖结局之间的关联以及体重减轻的影响,数据有限。本综述的目的是总结关于肥胖与PCOS患者辅助生殖结局之间关联的现有证据。越来越多的数据表明,肥胖与接受辅助生殖治疗的PCOS患者较低的妊娠率和活产率相关。然而,体重减轻是否能改善这种治疗的结局仍不清楚。值得注意的是,最近的指南指出,推迟妊娠以实现体重减轻的健康益处必须与随着年龄增长生育能力下降的风险相权衡。因此,如果在合理的时间段内未实现体重减轻,对于经过适当选择的PCOS患者,无论是否存在肥胖,都应提供辅助生殖治疗。