Efeito da orientação para perda de peso em pacientes inférteis com sobrepeso e obesidade
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2022-01-27
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Universidade Federal de Goiás
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Introduction: Obesity is considered a worldwide epidemic, being a serious
public health problem. Overweight and obesity are characterized by the
accumulation of body fat that poses a health risk. Several pathophysiological
disorders are caused by obesity, especially in people with Body Mass Index
(BMI) above 30 kg/m². It is increasingly common among women of
childbearing age. Obese women are three times more likely to suffer from
infertility than women with a normal body mass index.
Objective: Evaluate the response to weight loss guidance in anthropometric
parameters of obese and overweight infertile patients undergoing assisted
fertilization treatment (high and low complexity).
Methods: Retrospective cohort. A survey was carried out of a population of
overweight and obese infertile patients one to two years after the first visit. In
the first consultation at the assisted reproduction clinic (Human Reproduction
Laboratory HC / UFG) as obese and overweight patients were instructed to
lose weight and information that excess weight could decrease as chances of
being successful in the treatment. As endocrine variables, estradiol, FSH,
and LH were evaluated between obese and overweight patients in relation to
normal weight patients. Proportions were compared using the chi-square
test. Medians with the Mann-Whitney test. The H0 Rejection Level was 5%.
Results: The age of the patients and the values of FSH, LH and estradiol
were evaluated and paired, it was then verified that all presented p>0.05 after
the adjustments. The age range of patients ranged from 21 to 40 years, with
a mean of 35.59 ± 3.23 for the group with normal BMI and 35.78 ± 3.70dp for
the group classified as overweight and obese. The mean weight in kg before
and after orientation was 77.11±11.77 and 78.98±12.86 (p<0.0046). The
mean BMI (kg/m²) before guidance was 29.69 ± 3.75dp and after guidance
was 30.42 ± 4.32 (p<0.0038). Regarding ovulation, 31.6% of patients who
lost weight did not ovulate compared to 20.0% of patients who gained weight.
Patients who maintained their weight (16.7%) did not ovulate compared to
20.0% of patients who gained weight. Statistically non-significant difference.
As for the endocrine variables, FSH, LH and estradiol, when comparing the
population with normal weight with the population with overweight and
obesity, no significant differences were found.
Conclusions: There was a low percentage of weight loss in the patients, as
only 37.5% achieved this goal. A greater number of patients gained or
maintained their initial weight. Regarding ovulation, no significant
associations were found when comparing patients who lost weight and those
who gained weight, and also patients who maintained their weight compared
to those who gained weight. As for the endocrine variables, in this study, the
influence of obesity or overweight on these variables was not detected. The
main diagnosis of infertility was bilateral tubal obstruction due to tubal ligation
and other causes. Regarding the type of infertility, it was observed that cases
of the primary type were the most frequent.
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BENETTI, B. B. C. Efeito da orientação para perda de peso em pacientes inférteis com sobrepeso e obesidade. 2022. 102 f. Dissertação (Mestrado em Ciências da Saúde) - Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, 2022.