Does obesity compromise ovarian reserve markers? A clinician's perspective
Does obesity compromise ovarian reserve markers? A clinician's perspective
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DOI：
10.1007/s00404-012-2528-7
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发表时间：
2013-01-01
影响因子：
2.6
通讯作者：
Mittal, Suneeta
中科院分区：
文献类型：
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作者：
Malhotra, Neena;Bahadur, Anupama;Mittal, Suneeta
该研究的目的是确定体重指数（BMI）的增加是否会对接受体外受精（IVF）的亚洲裔不孕妇女的卵巢储备产生不利影响。这项前瞻性研究在印度新德里全印度医学科学研究所不孕不育诊所对183名妇女进行。所有患者在自然周期的第2/3天进行血液激素检测，包括促卵泡激素（FSH）、促黄体生成素（LH）和抑制素B。在月经周期第2-5天行阴道超声检查，检查卵巢腔卵泡计数（AFC）和卵巢体积。注意到BMI与卵巢储备参数如FSH、LH、抑制素B、窦卵泡计数和卵巢体积之间的相关性。三个BMI组的年龄具有可比性。平均不孕症持续时间为8.38年。与正常体重相比，超重和肥胖女性的抑制素B水平明显降低（p < 0.0259）。两组间AFC合计无统计学意义；而超重和肥胖女性右侧的AFC明显较低（p < 0.0129）。结合抗苗勒管激素，一种新的卵巢储备标记物，可能对这些肥胖的不孕妇女有益。需要进一步的工作来阐明肥胖对抑制素B的影响机制，抑制素B是不育妇女卵巢储备的标志。检查卵巢储备的最佳标志可能是女性在体外受精周期中的表现。然而，考虑到该过程的心理和经济压力，考虑通过此类研究对肥胖妇女在试管婴儿第一个周期的预期表现进行咨询似乎是明智的。
The aim of the study was to ascertain if increasing body mass index (BMI) adversely affects ovarian reserve among infertile women of Asian origin undergoing in vitro fertilization (IVF).This prospective study on 183 women was carried out in the infertility clinic of All India Institute of Medical Sciences, New Delhi, India. Blood hormonal assay in all patients including follicle-stimulating hormone (FSH), luteinizing hormone (LH) and inhibin B was performed on day 2/3 of a spontaneous cycle. A transvaginal ultrasonographic examination on day 2-5 of the menstrual cycle was done for antral follicle count (AFC) and ovarian volume. A correlation between BMI and ovarian reserve parameters like FSH, LH, inhibin B, antral follicle count and ovarian volume was noted.Age was comparable in the three BMI groups. The mean duration of infertility was 8.38 years. Compared to the normal weight, the overweight and obese women had a statistically significantly low inhibin B (p < 0.0259). The AFC when taken together on both sides was not statistically significant between the groups; however, the overweight and obese women had a significantly low AFC (p < 0.0129) on the right side.Incorporating anti-mullerian hormone, a newer marker for ovarian reserve, may benefit these obese infertile women. Further work is required to elucidate the mechanisms underlying the effect of obesity on inhibin B as a marker of ovarian reserve in infertile women. The best marker to check the ovarian reserve is perhaps the woman's performance during an IVF cycle. However, considering the psychological and financial stress of the procedure, it may seem wise to consider counseling of obese women on their expected performance in the first cycle of IVF through such studies.