School of Law, Università Politecnica delle Marche, Ancona, Italy.
Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University or Rome, Rome, Italy.
Acta Biomed. 2022 Aug 31;93(4):e2022278. doi: 10.23750/abm.v93i4.13466.
Obesity has been associated with reduced fertility, although the dynamics and mechanisms which link excess weight to reduced fertility are not yet fully clarified. Obese women, especially those with central obesity, are less likely to conceive per cycle. Obese women suffer from perturbations of the hypothalamus-pituitary-ovary axis, disturbances of the menstrual cycle and are up to three times more likely to suffer from oligo/anovulation. A delicate hormonal balance regulates follicular development and the maturation of oocytes and it has been observed that obesity can alter the hormonal environment: adipocytes, in fact, are responsible for the production of a hormone called leptin (present in high quantities in obese women) which has been associated with reduced fecundity. In addition to compromising ovulation, obesity negatively affects the development and implantation of the endometrium. The expression of polycystic ovary syndrome (PCOS) is regulated, in part, by weight, so obese women with PCOS often have a more severe phenotype and higher subfertility rates. Furthermore, obesity impairs women's response to medically assisted procreation (MAP) treatments. The authors have set out to delineate a broad-ranging overview of obesity's impact on female fertility, by drawing upon sources spanning the 1994-2022 period. Assisted reproductive technology (ART) procedures are also discussed as they relate to obese patients. In addition the dynamics by which maternal obesity reportedly affects fetal, neonatal and child development have also been briefly enunciated.
肥胖与生育力降低有关，尽管将体重过多与生育力降低联系起来的动态和机制尚未完全阐明。肥胖女性，尤其是中心性肥胖的女性，每个周期的受孕几率较低。肥胖女性的下丘脑-垂体-卵巢轴受到干扰，月经周期紊乱，发生少排卵或无排卵的风险增加 3 倍。微妙的激素平衡调节卵泡发育和卵母细胞成熟，已经观察到肥胖会改变激素环境：脂肪细胞实际上负责产生一种称为瘦素的激素（在肥胖女性中含量很高），与生育力降低有关。除了影响排卵外，肥胖还会对子宫内膜的发育和着床产生负面影响。多囊卵巢综合征（PCOS）的表达部分受到体重的调节，因此患有 PCOS 的肥胖女性通常表现出更严重的表型和更高的低生育力率。此外，肥胖会影响女性对医学辅助生殖（MAP）治疗的反应。作者通过参考 1994 年至 2022 年期间的各种来源，概述了肥胖对女性生育力的广泛影响。还讨论了与肥胖患者相关的辅助生殖技术（ART）程序。此外，还简要阐述了据报道母体肥胖如何影响胎儿、新生儿和儿童发育的动态。
