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Médecine de la Reproduction

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Nutrition and reproduction: female aspects Volume 13, issue 4, Octobre-Décembre 2011

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Authors
CHU Jean-Verdier (AP-HP), université Paris-XIII, service de médecine de la reproduction, avenue du 14-juillet, 93140 Bondy, France, CHU Jean-Verdier (AP-HP), université Paris-XIII, service d’histo-embryologie, cytogénétique, CECOS, avenue du 14-juillet, 93140 Bondy, France, Université Paris-XIII, CRNH IdF, unité de recherche en épidémiologie nutritionnelle, UMR U557 Inserm, U1125 Inra, Cnam, 93017 Bobigny, France, CHU Avicenne (AP-HP), département de santé publique, UP13, 93009 Bobigny, France

Overweight and obesity are increasingly prevalent in women of reproductive age, and are more and more frequent in patients consulting for infertility. Both are linked to a reduction of natural reproductive performance. Abdominal fat through insulin resistance, compensatory hyperinsulineamia and hyperandrogenism is responsible of ovulatory disorders in predisposed patients. Screening and management of metabolic syndrome must be systematically undertaken in anovulatory obese patients. A relatively small weight loss can restore spontaneous ovulation or improve the efficacy of ovulation induction treatment. Diet per se can also affect ovulatory function. A mediterranean dietary regime and increased physical activity should be adopted as first-line therapy. This simple approach has to precede the initiation of specific treatments and can be sufficient to obtain the expected pregnancy. In patients without ovulatory disorders, overweight and obesity lengthen the time to pregnancy, decrease the likelihood of success of infertility treatment and increase the risk of miscarriage. Mediterranean dietary pattern and regular physical activity are linked as well to better chance of pregnancy following assisted reproductive treatment. Assessment of lifestyle and modification of unhealthy behavior by appropriate advice or specific management must be systematic, as is acid folic supplementation, in women willing to conceive.