Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome

Jungheim, Emily S.; Lanzendorf, Susan E.; Odem, Randall R.; Moley, Kelle H.; Chang, Aimee S.; Ratts, Valerie S.

doi:10.1016/j.fertnstert.2008.04.063

Cited by 109 publications

(88 citation statements)

References 27 publications

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“…Numerous studies have demonstrated decreased efficacy of fertility treatments in obese women 33,43 . As a result, some centers offering fertility treatments have put BMI limits on who they will treat and what types of treatment they will offer.…”

Section: Fertility Treatment For Obese Womenmentioning

confidence: 99%

Obesity and reproductive function

Klenov¹,

Jungheim²

2014

Current Opinion in Obstetrics &Amp; Gynecology

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SYNOPSISObesity is associated with multiple adverse reproductive outcomes, but the mechanisms involved are largely unknown. Public health scientists studying obesity and its effects on health outcomes have referred to obesity as a "complex system", defined as a system of heterogeneous parts interacting in nonlinear ways to influence the behavior of the parts as a whole 1,22 . By this definition, human reproduction is also a complex system which may explain some of the difficulty in identifying the mechanisms linking obesity and adverse reproductive function. Despite the difficulties, research on obesity and reproduction is important as there is an epidemic of obesity among reproductive age women with associated consequences for future generations. In this review we discuss the adverse reproductive outcomes associated with obesity and data from translational studies of the mechanisms involved. We conclude with a brief discussion of public health policy as it relates to the treatment of infertility in obese women. Keywords fertility; obesity; reproduction; public health MEASURING OBESITY AND REPRODUCTIVE RISKDisentangling the individual components of obesity associated with poor health outcomes is difficult. Body mass index (BMI) or overall body size adjusted for height, is obviously, the most accessible measure of obesity as the tools for measuring BMI are readily available. On the other hand, adiposity (regional or total body fat), adipokine production, and lifestyle components may also contribute individually or together to overall obesity-related health risk. The bulk of the work relating obesity to health risks has focused on chronic diseases, however, we are learning more about components of obesity that relate to reproductive risk.

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Section: Fertility Treatment For Obese Womenmentioning

confidence: 99%

Obesity and reproductive function

Klenov¹,

Jungheim²

2014

Current Opinion in Obstetrics &Amp; Gynecology

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“…Obese women with PCOS who also have hyperinsulinemia and impaired glucose tolerance are reported to have decreased fertilization and implantation rates compared to women with PCOS alone [9]. Morbidly obese women (BMI ≥40 kg/m) with PCOS have significantly lower pregnancy rates than women with PCOS alone [10]. The impact of obesity on reproductive health is particularly important because it can have long lasting consequences on future generations.…”

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confidence: 99%

The impact of obesity on egg quality

Purcell

Moley

2011

J Assist Reprod Genet

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136

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Obesity in women is a concern in many countries. This causes numerous health issues; however, this review focuses on the impact of obesity on women's reproduction, and in particular the oocyte. Data from infertility clinics and experimental animal models that address the effects of obesity are presented. Bidirectional communication and metabolic support from the surrounding cumulus cells are critical for oocyte development, and the impact of obesity on these cells is also addressed. Both oocyte maturation and metabolism are impaired due to obesity, negatively impacting further development. In addition to reproductive hormones, obesity induced elevations in insulin, glucose, or free fatty acids, and changes in adipokines appear to impact the developmental competence of the oocyte. The data indicate that any one of these hormones or metabolites can impair oocyte developmental competence in vivo, and the combination of all of these factors and their interactions are the subject of ongoing investigations.

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“…With respect to obese women seeking pregnancy, the use of fertility treatments including assisted reproductive technology are costly and frequently associated with poorer success in obese women compared to normal-weight women [105,117,118]. During the assisted reproductive technology process, obese women have a poorer response to gonadotropins thus requiring much higher doses of these expensive medications, produce fewer and poorer quality oocytes, generate poorer quality embryos, achieve lower pregnancy rates, and have higher miscarriage rates [119][120][121][122]. This review presents a background framework for a new hypothesis suggesting the involvement of AGEs and their receptors in COH in obese women.…”

Section: Resultsmentioning

confidence: 99%