Obesity is a risk factor for early pregnancy loss after IVF or ICSI

Fedorcsák, Péter; Storeng, Ritsa; Dale, Per Olav; Tanbo, Tom; Åbyholm, Thomas

doi:10.1034/j.1600-0412.2000.079001043.x

Cited by 157 publications

(100 citation statements)

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“…86 Finally, in recent studies on PCOS women conceiving after in vitro fertilization or intracytoplasmatic sperm injection, it was observed that those with obesity had higher Obesity and the polycystic ovary syndrome A Gambineri et al gonadotrophin requirement during stimulation, 87 fewer oocytes, a higher abortion rate and lower live-birth rate than their non-obese counterpart. 88 In conclusion, a decreased efficiency of the different treatments for ovulation and fertility induction may be expected in obese PCOS women. The presence of hyperinsulinemia is probably the major factor responsible for this undesirable condition.…”

Section: Androgen Abnormalitiesmentioning

confidence: 99%

Obesity and the polycystic ovary syndrome

et al. 2002

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The polycystic ovary syndrome (PCOS) is a condition characterized by hyperandrogenism and chronic oligo-anovulation. However, many features of the metabolic syndrome are inconsistently present in the majority of women with PCOS. Approximately 50% of PCOS women are overweight or obese and most of them have the abdominal phenotype. Obesity may play a pathogenetic role in the development of the syndrome in susceptible individuals. In fact, insulin possesses true gonadotrophic function and an increased insulin availability at the level of ovarian tissue may favour excess androgen synthesis. Obesity, particularly the abdominal phenotype, may be partly responsible for insulin resistance and associated hyperinsulinemia in women with PCOS. Therefore, obesity-related hyperinsulinemia may play a key role in favouring hyperandrogenism in these women. Other factors such as increased estrogen production rate, increased activity of the opioid system and of the hypothalamic-pituitary-adrenal axis, decreased sex hormone binding globulin synthesis and, possibly, high dietary lipid intake, may be additional mechanisms by which obesity favours the development of hyperandrogenism in PCOS. Irrespective of the pathogenetic mechanism involved, obese PCOS women have more severe hyperandrogenism and related clinical features (such as hirsutism, menstrual abnormalities and anovulation) than normal-weight PCOS women. This picture tends to be more pronounced in obese PCOS women with the abdominal phenotype.Body weight loss is associated with beneficial effects on hormones, metabolism and clinical features. A further clinical and endocrinological improvement can also be achieved by adding insulin-sensitizing agents and=or antiandrogens to weight reduction programmes. These obviously emphasize the role of obesity in the pathophysiology of PCOS.

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Section: Androgen Abnormalitiesmentioning

confidence: 99%

Obesity and the polycystic ovary syndrome

et al. 2002

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“…Our data suggest that the frequently reported fertility disorders in obese or diabetic women (Pasquali et al, 2003) may be not only due to the toxic effects of NEFA on granulosa cells, which mainly lead to amenorrhea (Mu et al, 2001), but could also originate from direct detrimental effects on the cumulus-oocyte complex. The latter could explain the disappointing IVF or intracytoplasmic sperm injection (ICSI) results, and the higher risk for early pregnancy loss in obese women, as has been documented by Fedorcsak et al (2000 and and Pasquali et al (2003). Ongoing research on humans should confirm or refute the validity of applying this bovine model in human studies.…”

Section: Introductionmentioning

confidence: 99%

The consequences of metabolic changes in high-yielding dairy cows on oocyte and embryo quality

Leroy

Soom

Opsomer

et al. 2008

Animal

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Unsatisfactory reproductive performance in dairy cows, such as reduced conception rates, in addition to an increased incidence of early embryonic mortality, is reported worldwide and has been associated with a period of negative energy balance (NEB) early post partum. Typically, NEB is associated with biochemical changes such as high non-esterified fatty acid (NEFA), high b-hydroxybutyrate (b-OHB) and low glucose concentrations. The concentrations of these and other metabolites in the follicular fluid (FF) of high-yielding dairy cows during NEB were determined and extensively analyzed, and then were replicated in in vitro maturation models to investigate their effect on oocyte quality. The results showed that typical metabolic changes during NEB are well reflected in the FF of the dominant follicle. However, the oocyte seems to be relatively isolated from extremely elevated NEFA or very low glucose concentrations in the blood. Nevertheless, the in vitro maturation models revealed that NEB-associated high NEFA and low glucose levels in the FF are indeed toxic to the oocyte, resulting in deficient oocyte maturation and developmental competence. Induced apoptosis and necrosis in the cumulus cells was particularly obvious. Furthermore, maturation in saturated free fatty acid-rich media had a carry-over effect on embryo quality, leading to reduced cryotolerance of day 7 embryos. Only b-OHB showed an additive toxic effect in moderately hypoglycemic maturation conditions. These in vitro maturation models, based on in vivo observations, suggest that a period of NEB may hamper the fertility of high-yielding dairy cows through increased NEFA and decreased glucose concentrations in the FF directly affecting oocyte quality. In addition to oocyte quality, these results also demonstrate that embryo quality is reduced following an NEB episode. This important observation may be linked to the typical diet provided to stimulate milk yield, or to physiological adaptations sustaining the high milk production. Research into this phenomenon is ongoing.

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“…These alterations may explain impaired ovulatory function and so reproductive health. Because of lower implantation and pregnancy rates, higher miscarriage rates, and increased maternal and fetal complications during pregnancy, obese women have a lower chance to give birth to a healthy newborn (3)(4)(5)(6). In this review, the effects of obesity on fertility and effective management of infertility in obese and overweight women is summarized.…”

mentioning

confidence: 99%

Impact of obesity on infertility in women

Dağ

Dilbaz

2015

J Turkish German Gynecol Assoc

216

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Review 111 IntroductionObesity, which is an important health issue, is a common problem among women of reproductive age. Obesity and overweight involves an abnormal and excessive fat accumulation that negatively affects the health of the body. According to the World Health Organization (WHO), if the body mass index (BMI) equals to or is greater than 25 kg/m 2 , it is considered overweight, whereas if the BMI equals to or is greater than 30 kg/m 2 , it is considered obesity (1). Obesity brings out many problems such as social, psychological, demographic, and health problems. It is related to increased health risks such as diabetes mellitus, hypertension, coronary heart disease, and osteoarthritis and is linked to various malignancies, particularly endometrium, breast, and colon cancers. Obesity also plays a significant role in reproductive disorders, particularly in women. It is associated with anovulation, menstrual disorders, infertility, difficulties in assisted reproduction, miscarriage, and adverse pregnancy outcomes. In obese women, gonadotropin secretion is affected because of the increased peripheral aromatization of androgens to estrogens. The insulin resistance and hyperinsulinemia in obese women leads to hyperandrogenemia. The sex hormone-binding globulin (SHBG), growth hormone (GH), and insulin-like growth factor binding proteins (IGFBP) are decreased and leptin levels are increased. Thus, the neuroregulation of the hypothalamic-pituitary-gonadal (HPG) axis deteriorates (2). These alterations may explain impaired ovulatory function and so reproductive health. Because of lower implantation and pregnancy rates, higher miscarriage rates, and increased maternal and fetal complications during pregnancy, obese women have a lower chance to give birth to a healthy newborn (3)(4)(5)(6). In this review, the effects of obesity on fertility and effective management of infertility in obese and overweight women is summarized. Epidemiology of obesityThe prevalence of obesity is increasing significantly worldwide. The International Obesity Task Force reported that 1,1 billion adults are overweight. They also reported that 312 million of them are obese (7). Approximately 3,4 million adults die each year because of health problems associated with obesity and being overweight. Of these, 44% of the problems are related to diabetes, 23% to ischemic heart disease, and between 7% and 41% to some malignancies associated with overweight and obesity (7). The prevelence of obesity has increased in developed countries because of a change in lifestyle, including reduced physical activity, changes in nutrition style, and an increased calorie intake (8). However, some other factors such as endocrine disorders, hormonal disorders, psychological disorders, and use of some drugs such as steroids and antidepressants may lead to obesity (9). The World Health Organization reported that 60% of women are overweight (≥25 kg/m 2 ) in the United States and most European countries and 30% of these are obese (≥30 kg/m 2 ) and 6% of these are mo...

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Obesity is a risk factor for early pregnancy loss after IVF or ICSI

Abstract: Obesity is an independent risk factor for early pregnancy loss. This risk is, in part, related to the lower number of collected oocytes in obese women.

Cited by 157 publications

References 0 publications

Obesity and the polycystic ovary syndrome

Obesity and the polycystic ovary syndrome

The consequences of metabolic changes in high-yielding dairy cows on oocyte and embryo quality

Impact of obesity on infertility in women

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