Obesity as a disruptor of the female fertility

master's thesis

• Title (croatian): Pretilost kao narušitelj reprodukcijske sposobnosti žena
• Author: Zrinka Šakić
• Mentor: Dinka Pavičić Baldani (mentor)
• Committee member: Dinka Pavičić Baldani (predsjednik povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Committee member: Lana Škrgatić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Obesity is increasing worldwide and has a detrimental influence on female reproductive health. Particularly in obese women the hypothalamic-pituitary-ovarian axis is disrupted and they frequently suffer from menstrual dysfunction which eventually leads to anovulation and infertility. Majority of women with an ovulatory disorder contributing to their infertility have polycystic ovary syndrome (PCOS) and a significant proportion of women with PCOS are obese. The development of obesity in women with PCOS, in turn, amplifies and may even unmask the biochemical and clinical abnormalities characteristic of this condition. In obesity, the adipocytes act as an endocrine organ through secretion of adipokines that are commonly involved in metabolic regulation and inflammatory process. Additionally, hormonal imbalance such as insulin resistance and hyperandrogenism further contribute to fertility dysfunction. Overweight and obese women have lower outcomes following fertility treatments than the normal population. They poorly respond to induction of ovulation, require higher doses of gonadotropins and longer treatment courses for follicular development and ovulatory cycles. Weight loss is essential for the improvement of reproductive outcomes in obese women with and without PCOS. Women should be provided with assistance to lose weight, including psychological support, dietary advice, exercise classes and where appropriate, weight reducing agents or bariatric surgery.

Abstract (croatian)

Učestalost pretilosti raste širom svijeta te ima štetan utjecaj na reproduktivno zdravlje žena. Osobito kod pretilih žena dolazi do poremećaja hipotalamičko-hipofizno-ovarijske osi te zbog toga često pate od menstrualne disfunkcije koja naposlijetku dovodi do anovulacije i neplodnosti. Većina žena s ovulacijskim poremećajem koji doprinosi njihovoj neplodnosti imaju sindrom policističnih jajnika (PCOS), a značajan udio žena s PCOS-om je pretilo. Razvoj gojaznosti kod žena s PCOS-om zauzvrat pojačava i može čak razotkriti biokemijske i kliničke abnormalnosti karakteristične za ovo stanje. Kod pretilosti adipociti djeluju kao endokrini organ putem izlučivanja adipokina koji su obično uključeni u regulaciji metabolizma i upalnom procesu. Osim toga, hormonalni disbalans, kao što su inzulinska rezistencija i hiperandrogenizam, dodatno doprinosi disfunkciji plodnosti. Žene s prekomjernom tjelesnom težinom i pretilošću imaju smanjene ishode nakon tretmana plodnosti u usporedbi s normalnom populacijom. One pokazuju slabiji odgovor na indukciju ovulacije, iziskuju veće doze gonadotropina te dulje liječenje za folikularni razvoj i ovulacijske cikluse. Gubitak težine je neophodan za poboljšanje reproduktivnih ishoda kod pretilih žena sa i bez PCOS-a. Ženama bi trebalo pružiti pomoć pri mršavljenju, uključujući psihološku podršku, savjete o prehrani, tečajeve vježbanja i, prema potrebi, sredstva za smanjenje tjelesne težine ili barijatrijsku kirurgiju.

• Keywords: obesity; female fertility; PCOS
• Keywords (croatian): pretilost; plodnost; PCOS
• Language: english
• URN:NBN: urn:nbn:hr:105:061188
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2020-07-17 08:35:03