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肥胖对男性和女性生殖结局的影响。

Impact of obesity on male and female reproductive outcomes.

机构信息

Department of Obstetrics & Gynecology, Wright Patterson Air Force Base, Wright Patterson AFB.

Department of Obstetrics & Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, USA.

出版信息

Curr Opin Obstet Gynecol. 2019 Aug;31(4):201-206. doi: 10.1097/GCO.0000000000000549.

Abstract

PURPOSE OF REVIEW

The association between obesity and infertility has gained increasing provider and public awareness. The purpose of this review is to outline the recent research into the pathophysiology regarding obesity and its impact of reproductive function in both women and men.

RECENT FINDINGS

A BMI more than 25 has a detrimental impact on the hypothalamus-pituitary-gonadal (HPG) axis in both men and women, leading to alterations of HPG hormones, gametogenesis, as well as an increase in inflammation and lipotoxicity from excessive adipose tissue. Additionally, BMI likely impacts assisted reproductive technology (ART) outcomes, with a greater influence on women than men. Studies regarding weight loss interventions are heterogenous in methods and outcomes, and it is difficult to extrapolate from current data if weight loss truly leads to improved outcomes.

SUMMARY

Elevated BMI induces changes in the HPG axis, hormone levels, gametogenesis, and adverse ART outcomes. Inconsistencies regarding weight loss interventions make it difficult to assess the impact on outcomes after weight loss interventions.

摘要

目的综述

肥胖与不孕不育之间的关联已引起越来越多的提供者和公众的关注。本文旨在概述最近关于肥胖及其对女性和男性生殖功能影响的病理生理学研究。

最新发现

BMI 超过 25 对男性和女性的下丘脑-垂体-性腺(HPG)轴都有不利影响,导致 HPG 激素、配子发生以及过多脂肪组织引起的炎症和脂毒性增加发生改变。此外,BMI 可能会影响辅助生殖技术(ART)的结果,对女性的影响大于男性。关于减肥干预的研究在方法和结果上存在差异,很难从现有数据推断减肥是否真的会带来更好的结果。

总结

BMI 的升高会引起 HPG 轴、激素水平、配子发生和不良的 ART 结果的改变。减肥干预措施的不一致性使得很难评估减肥干预后对结果的影响。

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