Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Health Services Research Unit, University of Aberdeen, Aberdeen, UK.
Obes Rev. 2021 Dec;22(12):e13325. doi: 10.1111/obr.13325. Epub 2021 Aug 13.
Being overweight or obese can have a negative impact on fertility outcomes. This systematic review updates randomized controlled trial (RCT) findings on the effectiveness of weight loss interventions in reducing weight and improving reproductive outcomes of women and men with overweight or obesity and infertility. Eligible studies, published since the last review, were identified by searching databases from March 20, 2016 until March 31, 2020. RCTs involving any type of lifestyle intervention were considered. Eight RCTs were identified and aggregated with seven RCTs included in our previous review. Meta-analyses revealed that women randomized to a combined diet and exercise intervention were more likely to become pregnant, risk ratio (RR) = 1.87 (95% CI 1.20, 2.93) and achieve a live birth RR = 2.20 (95% CI 1.23, 3.94), compared to women in control groups who received no or minimal intervention. This pattern was not replicated in trials where control groups received immediate access to assisted reproductive technology (ART). No eligible randomized trials involving men were identified. Data were largely obtained from small scale studies. Better designed, adequately powered, robust randomized trials are needed to better understand the effect of weight loss interventions on reproductive outcomes in both women and men.
超重或肥胖会对生育结果产生负面影响。本系统评价更新了随机对照试验（RCT）的发现，即体重减轻干预措施在减轻体重和改善超重或肥胖及不孕不育的女性和男性的生殖结果方面的有效性。自上次审查以来，符合条件的研究是通过搜索数据库确定的，检索时间为 2016 年 3 月 20 日至 2020 年 3 月 31 日。考虑了涉及任何类型生活方式干预的 RCT。确定了八项 RCT，并与我们之前综述中包含的七项 RCT 进行了汇总。荟萃分析显示，与接受无或最小干预的对照组女性相比，随机分配到联合饮食和运动干预的女性更有可能怀孕，风险比（RR）=1.87（95%CI 1.20，2.93），活产 RR=2.20（95%CI 1.23，3.94）。这种模式在对照组立即获得辅助生殖技术（ART）的试验中没有复制。未确定符合条件的涉及男性的随机试验。数据主要来自小规模研究。需要更好设计、充分有力、稳健的随机试验，以更好地了解体重减轻干预对女性和男性生殖结果的影响。
