Obesity and reproduction: a committee opinion

doi:10.1016/j.fertnstert.2015.08.018

Cited by 172 publications

(62 citation statements)

References 186 publications

(222 reference statements)

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“…The following independent variables were included in each model: age 19 , race 20 , ethnicity 21 , education 22 , marital status, BMI 23 , current or recent smoker 24 , menstrual regularity, contraceptive use, history of PCOS 25 , primary infertility, importance of post-surgical pregnancy, and surgical procedure.…”

Section: Methodsmentioning

confidence: 99%

Contraception and Conception After Bariatric Surgery

Menke

King

White

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To examine contraceptive practices and conception rates after bariatric surgery. Methods The Longitudinal Assessment of Bariatric Surgery-2 is a multicenter, prospective cohort study of adults undergoing first-time bariatric surgery as part of routine clinical care at 10 U.S. hospitals. Recruitment occurred between 2005 and 2009. Participants completed preoperative and annual post-surgical assessments for up to seven years until January 2015. This report was restricted to women 18–44 years old with no history of menopause, hysterectomy, or estrogen and progesterone therapy. Primary outcomes were self-reported contraceptive practices, overall conception rate and early (<18 months) post-surgical conception. Contraceptive practice (no intercourse, protected, unprotected, or tried to conceive) was classified based on the preceding year. Conception rates were determined from self-reported pregnancies. Results Of 740 eligible women, 710 (95.9%) completed follow-up assessment(s). Median (IQR) preoperative age was 34 (30–39) years. In the first postsurgical year, 12.7% (95%CI, 9.4–16.0) of women had no intercourse, 40.5% (95%CI, 35.6–45.4) had protected intercourse only, 41.5% (95%CI, 36.4–46.6) had unprotected intercourse while not trying to conceive, and 4.3% (95%CI, 2.4–6.3) tried to conceive. The prevalence of the first three groups did not significantly differ across the 7 years of follow-up (P for all >.05); however, more women tried to conceive in the second year (13.1%, 95%CI, 9.3–17.0; P<0.001). The conception rate was 53.8 (95%CI, 40.0–71.1) per 1,000 woman-years across follow-up (median [IQR]: 6.5 [5.9, 7.0] years); 42.3 (95%CI, 30.2–57.6)/1,000 woman-years in the 18 months after surgery. Age (ARR 0.41, [95% CI, 0.19–0.89] per 10 years, P=0.03), being married or living as married (ARR 4.76, [95% CI, 2.02–11.21], P<0.001), and rating future pregnancy as important preoperatively (ARR 8.50, [95% CI, 2.92–24.75], P<0.001) were associated with early conception. Conclusion Post-surgical contraceptive use and conception rates do not reflect recommendations for an 18-month delay in conception after bariatric surgery. Clinical Trial Registration ClinicalTrials.gov, NCT00465829.

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Section: Methodsmentioning

confidence: 99%

Contraception and Conception After Bariatric Surgery

Menke

King

White

et al. 2017

Obstetrics &Amp; Gynecology

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“…In women, metabolic disorders increase the risk of menstrual cycle abnormalities, ovulatory dysfunction, and decreased fecundity, which can cause a number of pregnancy complications, including hypertension, pre‐eclampsia, gestational diabetes, and fetal distress 30, 31. Adiponectin is the most abundant adipokine expressed in reproductive organs.…”

Section: Discussionmentioning

confidence: 99%

CpG Oligodeoxynucleotides Downregulate Placental Adiponectin and Increase Embryo Loss in Non‐Obese Diabetic Mice

Qin

Tian

Liu

et al. 2016

American J Rep Immunol

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ProblemCpG oligodeoxynucleotides (ODNs) can induce immunological changes in non‐obese diabetic (NOD) mice and increase embryo loss, but little is known about the mechanism. This study aimed to determine the role of adiponectin in CpG ODN‐induced pregnancy failure.Method of studyOligodeoxynucleotide 1826 was intraperitoneally injected to NOD mice, and ODN 2216, ODN 2006, and ODN 2395 were used to stimulate human trophoblast cell lines to investigate adiponectin expression patterns and its possible effects on trophoblast function.ResultsCpG ODNs downregulated adiponectin via the cJun N‐terminal kinase signaling pathway and led to increased embryo loss (from 6.9 to 33.3%). ODN 2006 impaired human trophoblast cell migration, which was successfully rescued by adiponectin treatment.ConclusionCpG ODNs decreased placental adiponectin expression in NOD mice and impaired human trophoblast function and was associated with increased embryo loss. Adiponectin may therefore play an important protective role in the prevention of bacteria‐induced pregnancy failure.

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“…In women, obesity is associated with a higher incidence of ovulatory disorders and idiopathic infertility (ASRM, 2015). On the other hand, obese women under treatment for infertility may face additional problems, such as the need for higher doses of drugs to induce/stimulate ovulation, oocyte morphological changes, reduction in fertilization and implantation rates, and embryo quality (ASRM, 2015; Provost et al ., 2016).…”

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confidence: 99%

“…On the other hand, obese women under treatment for infertility may face additional problems, such as the need for higher doses of drugs to induce/stimulate ovulation, oocyte morphological changes, reduction in fertilization and implantation rates, and embryo quality (ASRM, 2015; Provost et al ., 2016). Compared to women of normal body weight, obese women submitted to IVF may present reduced rates of clinical pregnancy and live births, with an increased rate of abortion (Provost et al ., 2016).…”

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confidence: 99%

“…Spermatogenesis requires a controlled testicular environment and intact endocrine signaling through the hypothalamic-pituitary-testicle axis; and the impact of obesity on fertility can be attributed mainly to the endocrine mechanisms that alter this relationship (MacDonald et al ., 2010; Fariello et al . 2012; ASRM, 2015). Moreover, the preferential buildup of toxic substances and fat-soluble endocrine disruptors in adipose tissue, and hyperthermia resulting from the buildup of adipose tissue around the scrotum cause oxidative stress to the testes, thus broadening these alterations (Fariello et al , 2012; Sermondade et al ., 2013, Taha et al , 2016).…”

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confidence: 99%

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