Abstract
Objective:Obesity is one of the extra hypothalamic-pituitary-ovarian axis factors that can influence ovulation. The isolated impact of obesity on ovulation without other comorbidities needs to be further studied. Our goal is to evaluate the association between the anovulation in the ultrasonographic monitoring of the ovulation cycle and the body mass increase of infertile patients without polycystic ovaries of a university service.Methods:Case-control study performed at the Human Reproduction Laboratory of the University Hospital. We evaluated 1,356 ultrasound monitoring reports of ovulation between January 2011 and December 2015. We named case those patients who ovulated on the monitored cycle. After applying the exclusion criteria, we consolidated a total of 110 cases and 118 controls. The exposure variables were normal BMI or patients classified with a BMI above normal. Data analysis was performed using SPSS 22.0. Differences in proportions were assessed by X2 test Pearson, Fisher and Wilcoxon test. The value of p<0.05 was considered statistically significant.Results:The groups were comparable in age, age at menarche, number of pregnancies, deliveries, cesarean sections and abortions, number of antral follicles, FSH, prolactin and TSH values. Among the anovulatory patients, 57 (51.82%) were overweight, while among ovulatory patients, 44 (37.29%) were in this same BMI category. The odds ratio was 1.8655, with a significant p value (p<0.05).Conclusion:There was an association between anovulation and increase in the Body Mass Index, with an increased risk of anovulation in patients with BMI above normal.
Highlights
Menstruation is a cyclic endometrial desquamation resulting from the interactions of hormones produced by the hypothalamic-pituitary-ovarian axis
The integrity of the hypothalamic-pituitary-ovarian axis is essential for ovulation and regular menstrual cycles, and external factors may influence this complex feedback system (Speroff & Fritz, 2005)
Several pathophysiological disorders are caused by obesity, especially in people with Body Mass Indexes (BMI) above 30 kg/m2
Summary
Menstruation is a cyclic endometrial desquamation resulting from the interactions of hormones produced by the hypothalamic-pituitary-ovarian axis. The integrity of the hypothalamic-pituitary-ovarian axis is essential for ovulation and regular menstrual cycles, and external factors may influence this complex feedback system (Speroff & Fritz, 2005). Obesity is one of the factors that can influence the menstrual cycle. It can be defined as a disease characterized by excessive accumulation of body fat, due positive energy balance, causing health effects, with significant loss in quality and lifetime. In the United States, about 68% of the adult population is overweight, and about 34.9% are obese (Ogden et al, 2014). According to the Brazilian Ministry of Health, in the adult population in Brazilian capitals, overweight prevalence is of 49.1% among women. In Goiânia, the state capital of Goiás (Brazil), 48.1% of women are overweight and 16.3% are obese (Brazil-Ministério da Saúde, 2015)
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