Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
Panminerva Med. 2019 Mar;61(1):58-67. doi: 10.23736/S0031-0808.18.03490-0. Epub 2018 Jun 28.
As the global mean Body Mass Index (BMI) is on the rise, the importance of understanding exactly how female fertility is impacted by once outlier BMI values, becomes ever more important. Studies have implicated abnormal BMI on the female reproductive system by contributing to anovulation, irregular menses, adverse oocyte quality, endometrial alterations, and hormonal imbalances. These well ultimately result in female infertility, which could complicate natural conception efforts and request considering assisted reproductive technology (ART) in such couples. With an increase in the demand for ART, it is crucial to understand what factors can be altered by the female BMI in order to maximize the opportunity for successful pregnancy. The current manuscript aimed to review the information about the effect of BMI on the female fertility and ART outcomes. The complex nature of the female reproductive system leaves space for multiple factors to adversely affect its processes. Imbalances in the hypothalamus-pituitary-ovarian axis can impede efforts for couples to conceive. Leptin and estrogen are two hormones that have been implicated in regulating BMI as well as reproductive physiology. Lifestyle modifications prior to, and during ART have shown promise in enhancing fecundity. The intricacies in female reproductive system leaves much to the unknown, and often with conflicting results. Further research is required to fully elucidate what aspects of female fertility are influenced by BMI, and how the healthcare provider can facilitate successful outcomes. The current review will enable a better consultation and treatment.
随着全球平均体重指数(BMI)的上升,了解女性生育力究竟是如何受到曾经的 BMI 值异常的影响变得越来越重要。研究表明,异常的 BMI 通过导致无排卵、月经不规律、卵子质量差、子宫内膜改变和激素失衡,对女性生殖系统产生影响。这些最终会导致女性不孕,这可能会使自然受孕的努力变得复杂,并要求在这些夫妇中考虑辅助生殖技术(ART)。随着对 ART 的需求增加,了解女性 BMI 可以改变哪些因素以最大限度地提高成功怀孕的机会至关重要。本手稿旨在回顾关于 BMI 对女性生育力和 ART 结局的影响的信息。女性生殖系统的复杂性为多个因素对其过程产生不利影响留出了空间。下丘脑-垂体-卵巢轴的失衡可能会阻碍夫妇受孕的努力。瘦素和雌激素是两种被认为可以调节 BMI 以及生殖生理学的激素。在 ART 之前和期间进行的生活方式改变已显示出在提高生育能力方面的前景。女性生殖系统的复杂性使得许多方面仍然未知,而且常常结果相互矛盾。需要进一步的研究来充分阐明 BMI 影响女性生育力的哪些方面,以及医疗保健提供者如何促进成功的结果。本综述将有助于更好的咨询和治疗。