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Query: UMLS:C0497406 (overweight)
 26,365 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Historical data from 26 638 20-to 40-year women were used to study the association between obesity and menstrual abnormalities including evidence of infertility. It was found that women with evidence of anovulatory cycles, ie, irregular cycles greater than 36 days, and hirsutism, were more than 30 lb (13.6 kg) heavier than women with no menstrual abnormalities after adjusting for height and age. The percentage of women with evidence of anovulatory cycles was 2.6 per cent for women less than 20 per cent overweight, 4.0 per cent for women 20-49 per cent overweight, 5.8 per cent for women 50-74 per cent overweight., and 8.4 per cent for women more than 74 per cent overweight Women with a single menstrual abnormality including cycles greater than 36 days, irregular cycles, virile hair growth with facial hair, or heavy flow were also significantly heavier than women with normal values for these factors. A longer duration of obesity was associated with facial hair. Another analysis found that teenage obesity was greater for never-pregnant married women than for previously pregnant married women and for women having ovarian surgery for polycystic ovaries than for women having ovarian surgery for other reasons. This also supports an association of obesity with anovulatory cycles. These findings showing evidence of abnormal ovulation, menstrual abnormalities and excess hair growth in obese women may be explained by the recent studies of others demonstrating an association between obesity and hormonal imbalances.
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PMID:The association of obesity with infertility and related menstural abnormalities in women. 52 19

A retrospective case-referent study was performed to analyse risk factors of perinatal mortality. Overweight defined by body mass index, smoking greater than 10 cigs/day, infertility, earlier birth weight, earlier perinatal death were significant risk determinants of the obstetric history. Overweight and smoking, measured by the etiologic fractions, had the greatest impact on perinatal mortality. Significant risk factors of the present pregnancy were low weight gain, pre-eclampsia, cervical incompetence, and late hemorrhage. Intra-uterine growth retardation had the highest etiologic fraction. High risk assessment at the first antenatal visit had a sensitivity of 45%, increasing to 72% when adding supervening pregnancy complications. Although the positive predictive value of high-risk classification was very low, 2/3 of the perinatal deaths occurred among high-risk cases.
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PMID:Risk determinants of perinatal mortality in a Swedish county, 1980-1984. 209 38

The cult of a slim body without the slightest bit of adipose tissue and the food restriction or selection habits it creates are extremely common in our society. Their influence on menstrual cycle and female infertility is not negligible. A vegetarian low calorie diet may induce cycle disorders and a short luteal phase. Disturbances in the pulsatility of gonadotropic hormones are responsible for anovulation, and they occur when slimness with excessive reduction of the body fat mass is associated with psycho-socio-professional stress factors or with intensive sporting activities. The greater frequency of dysovulation in obese women, notably those who put on weight rapidly, is accompanied by numerous hormonal changes, including reduced sex hormone-binding globulin, increased ovarian and adrenal androgen production, increased peripheral aromatization of androgens to oestrogens, and altered gonadotropin pulsatile secretion. The hyperinsulinism consecutive to insulin resistance in obese subjects might act as co-factor of the luteinizing hormone and as such participate in abnormalities of follicular maturation by stimulating the insulin-like growth factor and the ovarian androgens. However, the relative importance of these various factors in the physiopathology of abnormal ovulation remains to be determined. Overweight reduces the effectiveness of clomiphene citrate, menopausal gonadotropins and gonadotropin-releasing hormone in stimulating the follicles. Weight loss reduces hormonal disturbances and facilitates follicular maturation and ovulation in spontaneous or induced cycles.
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PMID:[Influence of abnormal weight and imbalanced diet on female fertility]. 214 38

Overall 1,021 patients with endometrial carcinoma were treated between 1965 and 1982 at the Department of Obstetrics and Gynecology and the Department of Radiology, Friedrich-Schiller-University, Jena. The 5-year-survival rate of all patients amounted to 63%. The 5-year-survival probability with primary surgery was 76.1%, with primary irradiation 34.4%. The frequency of risk factors in the patient group was compared with an age adjusted group of patients who underwent a D & C due to irregular bleeding of benign causes. Overweight and infertility were evaluated as significantly more frequent risk factors in cancer patients. There was no significant difference between the two groups concerning the factors hypertension, diabetes, heart-diseases, irregular bleeding and history of carcinoma in the family.
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PMID:[Results of therapy of endometrial carcinoma and analysis of risk factors in comparison with a control group]. 275 77

From 1984 to 1985, 18 patients with infertility and oligomenorrhoea were treated with pulsatile GnRH administration (Zyklomat). According to the hormone levels and the ultrasonographic observation of the ovaries, they could be divided into two categories, group A (n = 11), patients with hyperandrogenaemia, and group B (n = 7), patients with hypothalamic amenorrhoea. As in hyperandrogenaemic patients a pathological LH-secretion pattern was suspected, assessment of LH-pulsing (5 ml blood samples at 10 min intervals over 6 h) was performed in this group of patients followed by an oestrogen-gestagen (E-Ge) suppression. One day before discontinuation of this medication, the GnRH pump was applied intravenously. Ovulation induction was more successful in group B than in group A. Hyperandrogenaemic women, in whom ovulation could be induced by the GnRH pump, exhibited higher basal concentrations of FSH, LH, LH/FSH ratio, oestradiol- 17 beta and testosterone (T) than the women not responding to pulsatile GnRH administration. The suppression of T and LH/FSH ratio with E-Ge treatment was more pronounced, while the non-responders had higher basal prolactin concentrations as well as after E-Ge therapy and a significantly greater body weight. The results indicate that GnRH therapy in hypothalamic amenorrhoea is more successful than in hyperandrogenaemia. Overweight hyperandrogenaemic patients appeared to be unsuitable for GnRH treatment, even after previous suppression of the hypothalamic pituitary ovarian axis with E-Ge.
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PMID:Pulsatile gonadotrophin releasing hormone therapy in patients with hyperandrogenaemia or hypothalamic amenorrhoea. 305 55

Three hundred seventy-six infertile women in whom there was evidence of ovulatory dysfunction were compared to fertile controls to determine if being excessively under or overweight at the time of planned conception was associated with an increased risk of infertility. In nulligravid women (n = 204), body weight for height 85% or less than "ideal" was associated with a 4.7-fold increase in risk (95% confidence interval = 1.5 to 14.7) of infertility associated with ovulatory dysfunction. Nulligravid women who were 120% or more over their ideal weight were also at increased risk for ovulatory infertility (relative risk = 2.1, 95% confidence interval = 1.0 to 4.3). Neither association was seen among women who had been previously pregnant. The presence of abnormalities of endocrinologic reproductive function in underweight and overweight women argues that the associations we have noted in nulligravid women represent cause-and-effect relationships. If so, we estimate that 6% of primary infertility in which ovulatory dysfunction is present results from being excessively underweight, and another 6% from being excessively overweight.
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PMID:Risk of ovulatory infertility in relation to body weight. 318 84

In attempt to optimize gonadotropin-releasing hormone (GnRH) treatment of anovulation, we compared the effect of intravenous GnRH administration at three pulse intervals (PI) during 63 cycles in 30 anovulatory patients who had: (1) amenorrhea secondary to anorexia nervosa (group I: 10 patients, 21 cycles); (2) unexplained anovulation with normal to high luteinizing hormone plasma levels (group II: 12 patients, 24 cycles); and (3) polycystic ovarian disease (PCOD) (group III: 8 patients, 18 cycles). Ovulation was achieved more frequently in group I (85%) than in group II (41%) or in group III (50%). In both groups I and II, the frequency of ovulatory responses was not different with the PI used, and 6 of the 17 women treated for infertility conceived; 3 with 90-minute PIs, 2 with 64-minute PIs, and 1 with 128-minute PIs. In women with PCOD, seven of the nine ovulatory responses and three pregnancies were obtained with 128-minute PIs. The overweight women with PCOD did not respond reliably to GnRH at the doses used, i.e., 4 to 15 micrograms per pulse. In all groups, the urinary estrone and estradiol preovulatory peak, duration of luteal phase, progesterone levels, and preovulatory follicle diameter were unrelated to the frequency of GnRH administration.
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PMID:Influence of the frequency of gonadotropin-releasing hormone (GnRH) administration on ovulatory responses in women with anovulation. 389 25

The definition, early history, and practical implications of family planning are discussed as well as the age groups affected by it, choice of contraceptive methods, and effect on abortion rate. The introduction of oral contraceptives in the 1960's revolutionalized sexual behavior, but had a detrimental effect on family life. In Finland, a new law was passed in 1972 to prevent unwanted pregnancies and to help plan family size by providing advice about contraceptive use. As early as the 1800's there were efforts to disseminate information about family planning, but programs began in earnest only in the 1960's and 1970's. Advice about family planning is especially important to underage groups, those wishing childspacing, women over 40 -- because of risk of birth defects -- and to women whose health is threatened by complications in pregnancy. In Finland about 16,000 abortions are performed per year (most of the decisions are attributable to social reasons), and worldwide 50,000,000 procedures take place annually. 1/10 of all marriages in Finland are childless because of infertility (50% of infertile persons are women, 40% men). The choice of contraceptives is important: condoms protect not only against unwanted pregnancy but also against venereal disease. About 13-14% of all women in Finland use the pill, which is better for young women than IUDs; however, the pill is not recommended for women over 35, nor for those who are overweight or who smoke. IUDs can cause pain or irregular menstruation, but these risks can be eliminated by proper examination before fitting. About 80% of IUd users are satisfied with the device. Recently, a hormonal IUD has been put on the market. The age of women bearing their 1st child has increased to 28-30 years because of modern contraceptives; and since fertility decreases after age 30-35, it is very likely that family size will be smaller in the future.
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PMID:[Family planning and contraception]. 691 67

During the years 1979-91 252 women with polycystic ovarian syndrome (PCOS) have been treated with ovarian electrocautery through the laparoscope in Aker University Hospital. Ovulation was obtained in 92% of the total series, and pregnancy in 84% of the women with PCOS as the sole cause of their infertility. Additional treatment with clomiphene citrate to the non-responders increased the pregnancy rate to 89%. The response to ovarian electrocautery was influenced by body weight, with an ovulation rae of 96-97% in the slim and moderately obese women decreasing to 70% in the really obese ones. When ovulation was established, the pregnancy rate per se was independent of body weight-when ovulation was established, the pregnancy rates of slim and overweight women with PCOS being 92% and 95%, respectively. In the responders (who ovulated following ovarian electrocautery), the annual rate of cessation of ovulation was 3-4% only. Even after a period of contraceptive use following the ovarian electrocautery, ovulation was resumed and pregnancy obtained within a few months. Therefore, ovarian electrocautery is proposed as the primary treatment in women with PCOS undergoing laparoscopy for any reason, infertility being a present, future or hypothetical problem only. When, on the other hand, infertility is not an issue, PCOS per se constitutes no reason to perform laparoscopy.
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PMID:Ovarian electrocautery in the treatment of women with polycystic ovary syndrome (PCOS). Factors affecting the results. 800 73

Several studies have examined the association between body mass index and infertility. We compared body mass index in 597 women diagnosed with ovulatory infertility at seven infertility clinics in the United States and Canada with 1,695 primiparous controls who recently gave birth. The obese women (body mass index > or = 27) had a relative risk of ovulatory infertility of 3.1 [95% confidence interval (CI) = 2.2-4.4], compared with women of lower body weight (body mass index 20-24.9). We found a small effect in women with a body mass index of 25-26.9 or less than 17 [relative risk (RR) = 1.2, 95% CI = 0.8-1.9; and RR = 1.6, 95% CI = 0.7-3.9, respectively). We conclude that the risk of ovulatory infertility is highest in obese women but is also slightly increased in moderately overweight and underweight women.
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PMID:Body mass index and ovulatory infertility. 817 1


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