Human Reproduction Update Advance Access originally published online on January 31, 2006
Human Reproduction Update 2006 12(3):193-207; doi:10.1093/humupd/dmk003
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Nutrition and reproduction in women
The ESHRE Capri Workshop Group11 To whom correspondence should be addressed at: P.G.Crosignani, Il Department of Obstetrics and Gynaecology, University of Milano, Via Commenda 12, 20122 Milano, Italy. E-mail: piergiorgio.crosignani{at}unimi.it
Submitted on December 5, 2005; accepted on December 20, 2005
Malnutrition is a major problem in developing countries, and obesity and eating disorders are increasingly common in developing as well as developed countries. The reproductive axis is closely linked to nutritional status, especially undernutrition in the female, and inhibitory pathways involving detectors in the hind brain suppress ovulation in subjects with weight loss. Recovery may occur after minimal reacquisition of weight because energy balance is more important than body fat mass. Anorexia nervosa and bulimia nervosa affect up to 5% of women of reproductive age causing amenorrhoea, infertility and, in those who do conceive, an increased likelihood of miscarriage. Obesity can affect reproduction through fat cell metabolism, steroids and secretion of proteins such as leptin and adiponectin and through changes induced at the level of important homeostatic factors such as pancreatic secretion of insulin, androgen synthesis by the ovary and sex hormone-binding globulin (SHBG) production by the liver. WHO estimates that 9 to 25% of women in developed countries are severely obese, and obese mothers are much more likely to have obese children, especially if they have gestational diabetes. Obesity-associated anovulation may lead to infertility and to a higher risk of miscarriage. Management of anovulation with obesity involves diet and exercise as well as standard approaches to ovulation induction. Many obese women conceive without assistance, but pregnancies in obese women have increased rates of pregnancy-associated hypertension, gestational diabetes, large babies, Cesarean section and perinatal mortality and morbidity. Among contraceptors, the fear of weight gain affects uptake and continuation of hormonal contraceptives, although existing trials indicate that any such effects are small. For all methods of hormonal contraception, weight above 70 kg is associated with increased failure rates.
Key words: contraception / miscarriage / nutrition / obesity / reproduction
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  I. Cetin, C. Berti, and S. Calabrese Role of micronutrients in the periconceptional period Hum. Reprod. Update, June 30, 2009; (2009) dmp025v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Hayden GnRH analogues: applications in assisted reproductive techniques Eur. J. Endocrinol., December 1, 2008; 159(suppl_1): S17 - S25. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E Koch, M Bogado, F Araya, T Romero, C Diaz, L Manriquez, M Paredes, C Roman, A Taylor, and A Kirschbaum Impact of parity on anthropometric measures of obesity controlling by multiple confounders: a cross-sectional study in Chilean women J Epidemiol Community Health, May 1, 2008; 62(5): 461 - 470. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Veleva, A. Tiitinen, S. Vilska, C. Hyden-Granskog, C. Tomas, H. Martikainen, and J. S. Tapanainen High and low BMI increase the risk of miscarriage after IVF/ICSI and FET Hum. Reprod., April 1, 2008; 23(4): 878 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Wakefield, M. Lane, S. J. Schulz, M. L. Hebart, J. G. Thompson, and M. Mitchell Maternal supply of omega-3 polyunsaturated fatty acids alter mechanisms involved in oocyte and early embryo development in the mouse Am J Physiol Endocrinol Metab, February 1, 2008; 294(2): E425 - E434. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. B. Ward Eating disorders in pregnancy BMJ, January 12, 2008; 336(7635): 93 - 96. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Zhang, M. A. Bosch, J. E. Levine, O. K. Ronnekleiv, and M. J. Kelly Gonadotropin-Releasing Hormone Neurons Express KATP Channels That Are Regulated by Estrogen and Responsive to Glucose and Metabolic Inhibition J. Neurosci., September 19, 2007; 27(38): 10153 - 10164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Holness, N. D. Smith, G. K. Greenwood, and M. C. Sugden PPAR{alpha} activation reverses adverse effects induced by high-saturated-fat feeding on pancreatic beta-cell function in late pregnancy Am J Physiol Endocrinol Metab, April 1, 2007; 292(4): E1087 - E1094. [Abstract] [Full Text] [PDF]
|
|