Department of Medical Sciences, Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Universitaetsklinik fur Innere Medizin, Klinische Abteilung für Endokrinologie und Diabetologie, Medizinische Universitat Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
Wien Klin Wochenschr. 2022 Jan;134(1-2):56-62. doi: 10.1007/s00508-021-01986-w. Epub 2021 Dec 8.
The presence of obesity may significantly influence female fertility through various mechanisms. Impairment of the hypothalamic-pituitary-ovarian axis in obese women may induce anovulation and infertility. Obesity may have an effect on women's spontaneous and assisted conception rates, increased miscarriage rates, premature labor, stillbirth and perinatal risks, and menstrual irregularity. It has been suggested that weight loss improves reproductive outcomes due to fertility amelioration and an improvement in menstrual irregularity and ovulation. It is still not known which weight reduction procedures (changes in lifestyle, pharmacological management or bariatric intervention) result in optimal outcome on infertility. Currently, bariatric surgery is defined as the best available method for the management of obesity and its associated diseases.We have analyzed literature facts about effects of bariatric surgery on the function of the hypothalamic-pituitary-ovarian axis, polycystic ovary syndrome (PCOS), anti-Mullerian hormone (AMH) and sexual dysfunction in obesity and pregnancy in obesity. Immediate positive effects of bariatric surgery are evident at the moment, while for long-term outcomes more prolonged follow-up investigations should be done.
肥胖的存在可能通过多种机制显著影响女性生育能力。肥胖女性的下丘脑-垂体-卵巢轴功能障碍可能导致无排卵和不孕。肥胖可能对女性的自然受孕和辅助受孕率、流产率、早产、死产和围产期风险以及月经不规律产生影响。有研究表明，由于生育能力改善以及月经不规律和排卵的改善，体重减轻可以改善生殖结局。目前尚不清楚哪种减重程序（生活方式改变、药物管理或减重干预）对不孕不育的结果最佳。目前，减重手术被定义为治疗肥胖及其相关疾病的最佳方法。我们分析了有关减重手术对肥胖和肥胖妊娠中下丘脑-垂体-卵巢轴、多囊卵巢综合征（PCOS）、抗苗勒管激素（AMH）和性功能障碍的影响的文献事实。减重手术的即时积极影响是显而易见的，而对于长期结果，则需要进行更长期的随访研究。
