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Chirurgie bariatrique et fertilité

Bariatric surgery and fertility

  • Dossier Thématique / Thematic File
  • Published:
Obésité

Résumé

L’obésité est responsable du développement de plusieurs comorbidités, dont les troubles de la fertilité. Chez la femme, l’obésité peut entraîner une anovulation s’intégrant dans le cadre d’un syndrome des ovaires polykystiques ou d’un hypogonadisme central. Les anomalies ovocytaires, de développement embryonnaire ou endométriales restent très discutées. Chez l’homme, l’hypofertilité est associée à un hypogonadisme hypogonadotrope ou, selon une hypothèse plus récente, à une altération directe de la spermatogenèse. La chirurgie bariatrique connaît un grand succès en France depuis une quinzaine d’années, elle constitue un traitement efficace de l’obésité sévère permettant une perte de poids conséquente associée à une amélioration des comorbidités et de la morbimortalité. Plus de 50 000 interventions sont réalisées chaque année. Concernant la fertilité féminine, la chirurgie bariatrique semble avoir un effet positif sur la régulation des cycles menstruels et sur l’ovulation. Chez l’homme, elle permettrait une amélioration de l’hypogonadisme hypogonadotrope, mais ses effets sur les paramètres spermatiques semblent controversés. Par ailleurs, il n’existe que peu de données permettant de décrire l’impact de la chirurgie bariatrique avant assistance médicale à la procréation sur le devenir des embryons.

Abstract

Obesity is associated with various health consequences including infertility. In women, anovulation is most often linked to polycystic ovary syndrome or can be secondary to hypogonadotrophic hypogonadism. Hypogonadotrophic hypogonadism has also been described in men in several publications. More recent data suggest that obesity can induce direct spermatogenesis alteration. Bariatric surgery has become very popular in France in the last fifteen years. It is the most effective therapy in severe obesity and is associated with a significant and long-lasting weight loss and a significant decrease in obesity-related morbidity and mortality. More than 50,000 procedures are performed every year. Bariatric surgery has positive effects on menstrual cycles in women and on hypogonadism in men. But its effects on sperm parameters seem controversial. Furthermore, few data are available concerning the impact of bariatric surgery on assisted reproductive techniques (ART) outcomes.

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Authors and Affiliations

  1. Service de nutrition, hôpital européen Georges-Pompidou, 20 rue Leblanc, 75015, Paris, France

    C. Rives-Lange, S. Czernichow, C. Barsamian & C. Carette

  2. Université Paris-Descartes, Paris, France

    C. Rives-Lange, A. Ait Boudaoud & S. Czernichow

  3. Unité de diabétologie endocrinologie, hôpital européen Georges-Pompidou, Paris, France

    A. Ait Boudaoud, S. Czernichow & A. Radu

  4. Unité de nutrition, hôpital Ambroise-Paré, Boulogne-Billancourt, France

    M. Bretault

  5. Inserm US938, Sorbonne universités, UPMC, université Paris-VI, Saint-Antoine Research Center, Saint Antoine Hospital, Paris, France

    R. Lévy

  6. Service de biologie de la reproduction CECOS, AP–HP, hôpital Tenon, Paris, France

    R. Lévy

  7. Service de chirurgie, hôpital Ambroise-Paré, Boulogne-Billancourt, France

    J.-L. Bouillot

Authors
  1. C. Rives-Lange
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  2. A. Ait Boudaoud
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  3. S. Czernichow
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  4. M. Bretault
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  5. C. Barsamian
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  6. A. Radu
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  7. R. Lévy
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  8. J.-L. Bouillot
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  9. C. Carette
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Correspondence to S. Czernichow.

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Rives-Lange, C., Ait Boudaoud, A., Czernichow, S. et al. Chirurgie bariatrique et fertilité. Obes 12, 206–209 (2017). https://doi.org/10.1007/s11690-017-0569-6

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  • DOI: https://doi.org/10.1007/s11690-017-0569-6

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