Impact of obesity on reproductive outcomes after ovarian ablative therapy in PCOS: a collaborative meta-analysis |
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| Authors: | Leena R. Baghdadi Hatem Abu Hashim Saad A.K. Amer Stefano Palomba Angela Falbo Eftekhar Al-Ojaimi Johannes Ott Wenjie Zhu Herve´ Fernandez Ahmed Nasr Abdel Maguid Ramzy Justin Clark Suhail A.R. Doi |
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| Affiliation: | 1. Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt;2. Autism Research and Treatment Center, AL-Amodi Autism Research Chair, Department of Physiology, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia;1. Department of Biology, Medical Genetics and Ecology, Kursk State Medical University, Kursk, Russian Federation;2. Family Planning and Reproductive Health Clinic, Regional Perinatal Center, Kursk, Russian Federation;3. Department of Zoology and Theory of Evolution, Kursk State University, Kursk, Russian Federation;4. Department of Medical Biological Disciplines, Belgorod State National Research University, Belgorod, Russian Federation;5. Department of Pathophysiology, Sumy State University, Sumy, Ukraine;1. Department of Gynecology and Obstetrics, Bingol Solhan Government Hospital, Bingol, Turkey;2. Department of Gynecology and Obstetrics, Giresun Bulancak Government Hospital, Giresun, Turkey;3. Department of Gynecology and Obstetrics, Sami Ulus Women and Children’s Health Training and Research Hospital, Ankara, Turkey |
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| Abstract: | Obesity is known to interfere with reproductive outcomes in polycystic ovary syndrome. There is no consensus regarding the impact of obesity on reproductive outcomes after ovarian ablative therapy (OAT) and there is no level I evidence to answer this question. This systematic review and meta-analysis assessed the strength of the association between obesity and ovulation or pregnancy rates after OAT. MEDLINE and several other databases were searched from 2000 to September 2011 for studies reporting on OAT and reproductive outcomes. Data were synthesized to determine the relative risk of reproductive outcomes (ovulation and pregnancy) in lean (body mass index <25 kg/m2) compared with overweight or obese women. The study obtained 15 data sets (14 articles) for analysis, which included 905 subjects in the obese group and 879 subjects in the lean group. Lean women had increased ovulation rates (RR 1.43, 95% CI 1.22–1.66) compared with obese women. Pregnancy rates also showed a similar trend (RR 1.73, 95% CI 1.39–2.17). Reproductive outcomes were generally better in younger women, more recent studies and randomized controlled trials. It is concluded that lean women respond better to OAT than their obese counterparts. These epidemiological observations indicate that obesity alters reproductive outcomes after OAT negatively.Obesity is known to interfere with reproductive outcomes in polycystic ovary syndrome. There is no consensus regarding the impact of obesity on ovarian ablative therapy (OAT) and there is no level I evidence to answer this question. We therefore undertook a systematic review and meta-analysis to assess the strength of the association between obesity and ovulation or pregnancy rates after OAT. We searched MEDLINE and several other databases from 2000 to September 2011 for studies reporting on OAT and reproductive outcomes. Data were synthesized to determine the risk ratio of reproductive outcomes (ovulation and pregnancy) in lean (BMI <25 kg/m2) as opposed to overweight or obese women. We obtained 15 datasets (14 articles) for analysis, which included 905 subjects in the obese group and 879 subjects in the lean group. Lean women had increased ovulation rates (RR 1.43, 95% CI 1.22–1.66) as compared to obese women. Pregnancy rates also showed a similar trend (RR 1.73, 95% CI 1.39–2.17). Reproductive outcomes were generally better in younger women, more recent studies and randomized controlled trials. We conclude that lean women respond better to OAT than their obese counterparts. These epidemiological observations indicate that obesity alters reproductive outcomes after OAT negatively. |
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