RESEARCH PROPOSALTHE RELATIONSHIP BETWEEN OBESITY AND INFERTILITY

Fathiya Shariff Public Health Research Methods

Introduction/ Background Problem Statement Literature Review Research Question Foundational Model Purpose of the Study Design/Methodologies/ Variables Types of Analysis Conclusion

Introduction and Background

Fertility can be negatively impacted by obesity in both men and women.

In women it brings menstrual problems, does not allow ovulation and pregnancies usually result in miscarriages

Infertility in obese men may be the accumulation of fat tissue in the suprapubic and thigh region, causing elevated scrotal temperatures that may have detrimental effects on the sperms.

Introduction/Background

A study that helps couples who are obese to be healthy and lose weight before seeking fertility treatments is ideal for this research

An In vitro fertilization treatment known as IVF is nearly 15,000 dollars and cannot be afforded easily.

Introduction/Background

Studies have shown the relationship between obesity and infertility

When the women lost the weight it was easy for them to get pregnant, their self-esteem improved and it was also easy to keep the pregnancy without a miscarriage as was the case in most obese women.

Loosing weight does not help people with underlying health issues like fibroids, polycystic ovarian syndrome, polyps and low sperm count which affect fertility.

Problem Statement

Types of Study Reviewed Randomized and Non Randomized Women and Men Nutritional and Weight loss Dietician, Therapist and Infertility specialist

Literature Review

This study centered on preventing heart disease; however, the structure was directed toward obesity prevention and increasing physical activity

The research study criteria was infertility for over 2 years

Not being able to ovulate (BMI) 2=30, patent Fallopian tubes. Being prepared to take 6 months time out'

from conventional medical treatment for infertility.

Literature Review

The results indicate that lifestyle modification through exercise and sensible eating patterns can lead to improved reproductive function. These changes occurred with minimal weight loss, which is encouraging for women who have constantly failed to achieve reproductive success on a variety of short term low calorie diets.

Literature Review

Total Articles From SearchTwenty Five

Articles CategorizedTen

RandomizedFive

Non-RandomizedFive

Men Only

Studies

Four

Men and WomenStudies

None

Women Only

Studies

Two

Men Only Studies

Two

Men and Women Studies

None

Women Only

Six

Nutrition OnlyOne

Nutrition and Exercisesix

Nutrition OnlyTwo

Nutrition and Exercise

Eight

Does good nutrition and exercise help increase chances of ovulation in women hence increasing chances of getting pregnant

Does the fat in obese men increase temperatures that is bad for the sperms hence lowering the sperm count, mobility and mobility.

Research Questions

Exercise & Good Nutrition

Foundational Model

Increased chances

of fertility

Dietician Assistance in Preparing Healthy Meals

Therapist to Assist with the psychological effects of infertility

Objectives The purpose of this study is to view the

relationship between obesity and infertility and to determine if loosing weight assisted

Ovulation Pregnancy Increased sperm count, mobility and

motility. Reduced Miscarriages.

Purpose of this Study

AIM- The Aim of this Research Study is lifestyle modification through exercise and sensible eating patterns can lead to improved reproductive function.

GOAL-The goal is weight loss and improved fertility with the assistance of dieticians, physical activity and a therapist.

Expected Outcome- Improved fertility through ovulation and pregnancies.

Purpose of this Study.

Lifestyle Change- The knowledge and education they learn should help them live healthier lives for themselves and the children they bring into this world.

Purpose of this Study

It was difficult to find studies that included both men and women so 3 studies were used which only had men or men.

18 Women consented to take part in the first study The women had been patients of the fertility clinic at the Queen Elizabeth Hospital for an average of 2 years and all had been treated previously.

Effects of being overweight and obesity on semen parameters and endocrine hormones in human males of the reproductive age was the 2nd study

The third study was for women who could not ovulate due to obesity.

Design and Methodologies

In the three study groups a treatment format emphasizing gradual dietary changes in conjunction with regular exercise was used .

The therapeutic team consisted of two infertility specialists and a psychiatrist

With experience in the treatment of obesity, a physiotherapist and a dietician.

A questionnaire was given at the end of the treatment for additional information and improvements.

Design and Methodologies

Dependent Variable◦ The dependent variables used were based on

obesity and infertility◦ A. Ovulation◦ B. Pregnancy◦ C. Dietary behaviors◦ D. Lifestyle Changes

Design and Methodologies

2 Statistical methods was used for the research studyPaired t-testAnalysis of Variance tests

The outcome was to determine the number of women who were able to ovulate and get pregnant.

Types of Analysis

There was a significant weight loss for the women who attended the program over the 6 months.

Those who had not conceived 9months after the end of the program continued to lose weight.

The profile of overweight and obese men clearly affects their semen parameters and testosterone levels.

Conclusion

1st study 2nd Study 3rd Study0

5

10

15

20

25

30

WomenMenPregnancy

Conclusion

Cabler, S., Agarwal, A., Flint, M., & Du Plessis, S. S. (2010). Obesity: modern man’s fertility nemesis. Asian J Androl, 12(4), 480-9.

Clark, A. M., Ledger, W., Galletly, C., Tomlinson, L., Blaney, F., Wang, X., & Norman, R. J. (1995). Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. Human Reproduction, 10(10), 2705-2712.

Diamanti‐Kandarakis, E., & Bergiele, A. (2001). The influence of obesity on hyperandrogenism and infertility in the female. Obesity reviews, 2(4), 231-238.

FEDORCSÁK, P., STORENG, R., DALE, P. O., Tanbo, T. O. M., & ÅBYHOLM, T. (2000). Obesity is a risk factor for early pregnancy loss after IVF or ICSI. Acta obstetricia et gynecologica Scandinavica, 79(1), 43-48.

Gao, Q., Wolfgang, M. J., Neschen, S., Morino, K., Horvath, T. L., Shulman, G. I., & Fu, X. Y. (2004). Disruption of neural signal transducer and activator of transcription 3 causes obesity, diabetes, infertility, and thermal dysregulation. Proceedings of the National Academy of Sciences of the United States of America, 101(13), 4661-4666.

Hammoud, A. O., Gibson, M., Peterson, C. M., Meikle, A. W., & Carrell, D. T. (2008). Impact of male obesity on infertility: a critical review of the current literature. Fertility and sterility, 90(4), 897-904.

Handel, L. N., Shetty, R., & Sigman, M. (2006). The relationship between varicoceles and obesity. The Journal of urology, 176(5), 2138-2140.

Hofny, E. R., Ali, M. E., Abdel-Hafez, H. Z., Kamal, E. E. D., Mohamed, E. E., Abd El-Azeem, H. G., & Mostafa, T. (2010). Semen parameters and hormonal profile in obese fertile and infertile males. Fertility and sterility, 94(2), 581-584.

Huber-Buchholz, M. M., Carey, D. G. P., & Norman, R. J. (1999). Restoration of Reproductive Potential by Lifestyle Modification in Obese Polycystic Ovary Syndrome: Role of Insulin Sensitivity and Luteinizing Hormone 1. The Journal of Clinical Endocrinology & Metabolism, 84(4), 1470-1474.

Jensen, T. K., Andersson, A. M., Jørgensen, N., Andersen, A. G., Carlsen, E., Petersen, J., & Skakkebæk, N. E. (2004). Body mass index in relation to semen quality and reproductive hormonesamong 1,558 Danish men. Fertility and sterility, 82(4), 863-870.

References

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Pasquali, R., Patton, L., & Gambineri, A. (2007). Obesity and infertility. Current Opinion in Endocrinology, Diabetes and Obesity, 14(6), 482-487.

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References

Sallmén, M., Sandler, D. P., Hoppin, J. A., Blair, A., & Baird, D. D. (2006). Reduced fertility among overweight and obese men. Epidemiology, 17(5), 520-523.

Teerds, K. J., De Rooij, D. G., & Keijer, J. (2011). Functional relationship between obesity and male reproduction: from humans to animal models. Human reproduction update, 17(5), 667-683.

van der Steeg, J. W., Steures, P., Eijkemans, M. J., Habbema, J. D. F., Hompes, P. G., Burggraaff, J. M., ... & Mol, B. W. (2008). Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. Human Reproduction, 23(2), 324-328.

Wang, J. X., Davies, M. J., & Norman, R. J. (2002). Obesity increases the risk of spontaneous abortion during infertility treatment. Obesity Research, 10(6), 551-554.

Wittemer, C., Ohl, J., Bailly, M., Bettahar-Lebugle, K., & Nisand, I. (2000). Does body mass index of infertile women have an impact on IVF procedure and outcome?. Journal of assisted reproduction and genetics, 17(10), 547-552.

References