Schon Samantha, Spizman Jocelyn, Stelmak Daria, Chames Mark, Pilarz Stacey, Abdur-Rahman Jamila, Jiang Charley, Othman Amal, Menke Marie
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, L4000 University Hospital South, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
University of Michigan Medical School, 1301 Catherine Street, Ann Arbor, MI, 48109, USA.
Reprod Biol Endocrinol. 2025 Jun 10;23(1):89. doi: 10.1186/s12958-025-01415-x.
Obesity is a highly prevalent chronic disease with a significant and complex impact on reproduction. National guidelines recommend weight loss prior to pregnancy for patients with obesity to mitigate complications and increase fertility; however, targeted, personalized interventions are limited. The objectives of this study are to describe the implementation of a multidisciplinary program designed specifically for women with reproductive disorders and obesity and to report differences in baseline characteristics and weight loss outcomes between women willing vs. not willing to defer pregnancy attempts to focus on weight loss.
Retrospective cohort study at a university multidisciplinary program for women with reproductive disorders and obesity. All participants from program initiation (November 2021) through July 2023 were included in the analysis. Primary outcome was percent body weight loss at 3 months. Secondary outcomes included weight loss at 6 months and achievement of > 5% and > 10% weight loss at each time point.
A total of 237 participants were included in the analysis. The majority of participants (88.2%) desired pregnancy. 63.2% of participants who desired pregnancy were willing to postpone pregnancy attempts/fertility treatments so that they could focus on weight loss for at least 3 months. Participants willing to defer pregnancy attempts achieved a significantly greater weight loss at 3 months compared to those who continued pregnancy attempts (mean - 4.8% vs. -2.5%, p = 0.004) and were more likely to achieve > 10% body weight loss at 3 months (14.0% vs. 2.20%, p = 0.031). Those who achieved > 5% weight loss by 6 months were more likely to achieve pregnancy within the first 6 months of trying to conceive (34.1% vs. 7.7%, p = 0.004).
We describe the development and implementation of a multidisciplinary program for women with reproductive disorders and obesity seeking weight management. An individualized approach to weight management and reproductive care results in clinically significant weight loss especially among women willing to defer pregnancy attempts and focus on weight loss for at least 3 months.
Clinical trial number: Not applicable.
肥胖是一种高度流行的慢性病，对生殖有着重大而复杂的影响。国家指南建议肥胖患者在怀孕前减重，以减轻并发症并提高生育能力；然而，有针对性的个性化干预措施有限。本研究的目的是描述一个专门为患有生殖障碍和肥胖症的女性设计的多学科项目的实施情况，并报告愿意与不愿意推迟怀孕尝试以专注于减重的女性在基线特征和减重结果方面的差异。
在一所大学针对患有生殖障碍和肥胖症的女性开展的多学科项目中进行回顾性队列研究。分析纳入了从项目启动（2021年11月）到2023年7月的所有参与者。主要结局是3个月时体重减轻的百分比。次要结局包括6个月时的体重减轻情况以及在每个时间点体重减轻超过5%和超过10%的情况。
共有237名参与者纳入分析。大多数参与者（88.2%）希望怀孕。希望怀孕的参与者中有63.2%愿意推迟怀孕尝试/生育治疗，以便能够专注于减重至少3个月。与继续尝试怀孕的参与者相比，愿意推迟怀孕尝试的参与者在3个月时体重减轻显著更多（平均-4.8%对-2.5%，p = 0.004），并且在3个月时更有可能体重减轻超过10%（14.0%对2.20%，p = 0.031）。在6个月时体重减轻超过5%的参与者在尝试受孕的前6个月内更有可能怀孕（34.1%对7.7%，p = 0.004）。
我们描述了一个针对寻求体重管理的患有生殖障碍和肥胖症的女性的多学科项目的开发和实施情况。个性化的体重管理和生殖护理方法会带来临床上显著的体重减轻，尤其是在那些愿意推迟怀孕尝试并专注于减重至少3个月的女性中。
临床试验编号：不适用。
