摘要女性肥胖与不良生育结局有关,包括不孕、生育力低下、流产、死产等,因此越来越多的肥胖女性寻求助孕治疗,然而肥胖也会降低辅助生殖的成功率,胚胎植入率、临床妊娠率、活产率降低,流产率、早产率增加,这些已是临床共识.女性肥胖影响辅助生殖结局的机制有很多研究,虽无明确的结论,但基本包括影响卵细胞、胚胎发育及子宫内膜容受性这三个环节.理论上,减重是改善肥胖女性辅助生殖结局的一线治疗方法,但现有资料及研究显示减重对于辅助生殖结局的影响仍有争议,减重的时机及理想体质量也没有统一标准,规律的运动、饮食结构的改变、减肥手术及联合使用某些药物对改善辅助生殖结局有重要意义.本文就现阶段女性肥胖影响辅助生殖结局的机制及干预措施进行综述.

abstractsFemale obesity is associated with infertility,subfertility,increased pregnancy loss,stillbirth and so on.Therefore,more and more obese women are seeking to fertility treatment.However,overweight and obese women also receive inferior assisted reproductive technology (ART) outcomes,such as implantation rate,clinical pregnancy rate,pregnancy loss rate,and live birth rate.The clinical impact of obesity on female infertility has been well characterized.There are many studies concentrating on the mechanism of female obesity affecting assisted reproductive outcomes,which include the poor occyte/embryo quality and negative effect on endometrial receptivity,but no clear answer has been obtained.Weight loss is the initial treatment to improve the ART outcomes of obese women theoretically.However,it is still controversial whether weight loss is indeed helpful and the appropriate time to lose weight and the ideal weight before fertility treatment are also unclear.Regular physical exercise,diet and bariatric surgery are of great significance in improving the assisted reproductive outcomes of obese women.This article reviews the mechanism and treatment of female obesity affecting assisted reproductive outcomes at present.