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Journal of Reproduction and Infertility، جلد ۲۱، شماره ۱، صفحات ۳۴-۴۲
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عنوان انگلیسی Obesity and Infertility: A Metabolic Assessment Strategy to Improve Pregnancy Rate
چکیده انگلیسی مقاله Background: The metabolic global approach is a multidisciplinary intervention for obese women before undergoing assisted reproductive techniques, with the goal of improving fertility and decreasing adverse pregnancy outcomes. The objective of this study was to evaluate the impact of the metabolic global approach on pregnancy rate. Methods: This retrospective cohort study included 127 women and was conducted at the Centre hospitalier de l'Université de Montréal fertility center. Eligibility included BMI at initial consultation of ≥30 kg/m2. Fertility treatments were considered when a weight loss of minimum 5% and normal metabolic indices were achieved. The p< 0.05 was considered statistically significant. Results: Median baseline and last clinical assessment BMIs were 38.2 kg/m² and 35.8 kg/m² respectively (p< 0.001), representing a median weight loss of 5.1%. At baseline, at least one metabolic parameter was abnormal in 66% of women. Total pregnancy rate was 53%. The majority of women (63%) who achieved pregnancy did so with weight loss and metabolic stabilization alone (11%) or combined with metformin (36%) and/or oral ovulation drugs (16%). Normal vitamin D (p< 0.001) and triglyceride levels (p< 0.05) as well as lower BMI after weight loss (p< 0.05) were associated with an increased relative risk of pregnancy. Conclusion: Replete vitamin D status, weight loss of 5% and lower BMI as well as normal triglyceride level are significant and independent predictors of pregnancy in obese women presenting to our fertility center. The metabolic global approach is an effective program to detect metabolic abnormalities and improve obese women's pregnancy rate.
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نویسندگان مقاله | Rachel Bond
Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l&apos;Université de Montréal (CRCHUM), Montreal, Quebec, Canada


| Alexandra Nachef
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada


| Catherine Adam
Endocrinology Division, Department of Medicine, Centre de Recherche du Centre Hospitalier de l&apos;Université de Montréal (CRCHUM), Montreal, Quebec, Canada


| Marielle Couturier
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada


| Isaac-Jacques Kadoc
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada


| Louise Lapensée
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada


| Gilles Bleau
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada


| Ariane Godbout
Clinique de Procréation Assistée du Centre Hospitalier de l&apos;Université de Montréal (CHUM), Department of Obstetrics and Gynecology, Montreal, Quebec, Canada
نشانی اینترنتی http://www.jri.ir/article/60069
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