Iavarone Irene, Mele Daniela, Caprio Francesca, Andreoli Giada, Vastarella Maria Giovanna, de Franciscis Pasquale, Ronsini Carlo
Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy.
Front Cell Dev Biol. 2024 Sep 30;12:1461132. doi: 10.3389/fcell.2024.1461132. eCollection 2024.
Ovulatory dysfunction is more common in women with obesity. Body fat distribution is also crucial because anovulatory women have a greater waist circumference and more abdominal fat than ovulatory women of similar BMI. The primary aim of the present study is to determine whether there is a relationship between BMI and reproductive characteristics, including hormonal values, antral follicle count (AFC), endometrial assessment at transvaginal ultrasound evaluation (TVUS) during controlled ovarian stimulation (COS), and oocyte retrieval after Ovum Pick-Up (OPU).
Data from a cohort of 183 patients were analyzed and divided into three groups based on weight status: normal weight, overweight, and obesity. Evaluated reproductive characteristics included: age, basal values of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-beta-estradiol (E2), thyroid stimulating hormone (TSH), anti-müllerian hormone (AMH), antral-follicle-count (AFC), duration of COS, E2, and progesterone at the last monitoring, TVUS endometrial thickness at the last monitoring before OPU, FOI after OPU. Additionally, the number of meiosis II oocytes retrieved (MII), the total dose of FSH administered, the ratio between MII and total FSH administered, and OSI were registered.
AMH levels were significantly lower in obese patients compared to normal weight and overweight women (1.05 IQR 1.20, 1.58 IQR 2.16, 1.32 IQR 1.38, respectively, -value = 0.032). When looking at the MII/FSH ratio, the normal weight group showed a median value of 3.3 with an IQR of 4.0, the overweight group showed a median value of 2.3 with an IQR of 1.9, and the obese group had a median value of 2.6 with an IQR of 2.8. Those data were statistically significant (-value = 0.049).
These results emphasize the importance of considering weight status in fertility assessment and treatment planning.
排卵功能障碍在肥胖女性中更为常见。体脂分布也很关键，因为无排卵女性比体重指数（BMI）相似的有排卵女性腰围更大且腹部脂肪更多。本研究的主要目的是确定BMI与生殖特征之间是否存在关联，这些生殖特征包括激素值、窦卵泡计数（AFC）、控制性卵巢刺激（COS）期间经阴道超声评估（TVUS）时的子宫内膜评估以及采卵（OPU）后的卵母细胞采集情况。
对一组183例患者的数据进行分析，并根据体重状况分为三组：正常体重、超重和肥胖。评估的生殖特征包括：年龄、促卵泡激素（FSH）、促黄体生成素（LH）、17-β-雌二醇（E2）、促甲状腺激素（TSH）、抗苗勒管激素（AMH）的基础值、窦卵泡计数（AFC）、COS持续时间、最后一次监测时的E2和孕酮、OPU前最后一次监测时的TVUS子宫内膜厚度、OPU后的获卵率（FOI）。此外，记录回收的减数分裂II期卵母细胞数量（MII）、给予的FSH总剂量、MII与给予的FSH总量之比以及卵母细胞成熟指数（OSI）。
与正常体重和超重女性相比，肥胖患者的AMH水平显著降低（分别为1.05，四分位间距[IQR]为1.20；1.58，IQR为2.16；1.32，IQR为1.38，P值 = 0.032）。在观察MII/FSH比值时，正常体重组的中位数为3.3，IQR为4.0；超重组的中位数为2.3，IQR为1.9；肥胖组的中位数为2.6，IQR为2.8。这些数据具有统计学意义（P值 = 0.049）。
这些结果强调了在生育力评估和治疗计划中考虑体重状况的重要性。
