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Gynäkologische Endokrinologie

, Volume 15, Issue 2, pp 126–130 | Cite as

Adipositas und kontrollierte ovarielle Stimulation (COH)

Leitthema
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Zusammenfassung

Hintergrund

Adipositas bei infertilen Frauen ist ein zunehmendes Problem mit Auswirkungen auf den Behandlungsverlauf, Schwangerschaftserkrankungen und die spätere gesunde kindliche Entwicklung.

Ziel der Arbeit

Es wird dargestellt, welchen Einfluss das Körpergewicht und insbesondere Übergewicht auf die hormonelle Stimulation bei Maßnahmen der künstlichen Befruchtung haben und wie sich Übergewicht auf die Erfolgsaussichten von Verfahren der assistierten Reproduktion auswirkt.

Ergebnisse

Adipöse Patientinnen zeigen eine deutlich schlechtere hormonelle Stimulierbarkeit, benötigen eine höhere Gonadotropindosis als Normalgewichtige und erzielen eine geringere Eizellzahl. Schwangerschafts- und Lebendgeburtenraten sind signifikant niedriger, die Abortrate ist höher. Eventuelle Vorteile einer intramuskulären Gonadotropingabe im Vergleich zur subkutanen Applikation sind nicht belegt.

Schlussfolgerung

Eine hormonelle Stimulierbarkeit ist bei adipösen Patientinnen zwar gegeben, aber signifikant schlechter als bei Normalgewichtigen. Daher sollte eine prätherapeutische Gewichtsreduktion dringend empfohlen werden, vor allem bei extremer Adipositas.

Schlüsselwörter

In-vitro-Fertilisation Gonadotropine Schwangerschaftsrate Lebendgeburt Spontanabort 

Obesity and controlled ovarian stimulation (COH)

Abstract

Background

Obesity in infertile women is an endemic problem and has a direct impact on assisted reproductive technology (ART) treatment, in vitro fertilization (IVF) outcome, pregnancy, and development of children in later life.

Objective

The impact of body weight and obesity on controlled ovarian stimulation (COH) for ART and ART outcome is illustrated.

Results

Patients who are obese show a reduced ovarian response to COH, require a higher dose of gonadotropins, and have a reduced oocyte yield compared to normal weight women. Pregnancy and live birth rates are significantly lower, while the miscarriage rate is increased. There is no proven benefit of intramuscular vs. subcutaneous administration route.

Conclusions

Controlled ovarian stimulation is feasible in obese patients, but is significantly worse compared to normal weight patients. Thus, pretherapeutic weight reduction is urgently recommended, particularly in patients with extreme obesity.

Keywords

Fertilization in vitro Gonadotropins Pregnancy rate Live birth Abortion, spontaneous 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

T. Strowitzki und E. Capp geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  1. 1.Abteilung für Gynäkologische Endokrinologie und FertilitätsstörungenUniversitätsklinikum HeidelbergHeidelbergDeutschland
  2. 2.Departamento de Ginecologia e Obstetrícia, Faculdade de MedicinaUniversidade Federal do Rio Grande do SulPorto AlegreBrasilien

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