Ovulatory status of overweight women without Polycystic Ovary Syndrome.

OBJECTIVE: Obesity is one of the extra hypothalamic-pituitary-ovarian axis factors that can influence ovulation. The isolated impact of obesity on ovulation without other comorbidities needs to be further studied. Our goal is to evaluate the association between the anovulation in the ultrasonographic monitoring of the ovulation cycle and the body mass increase of infertile patients without polycystic ovaries of a university service. METHODS: Case-control study performed at the Human Reproduction Laboratory of the University Hospital. We evaluated 1,356 ultrasound monitoring reports of ovulation between January 2011 and December 2015. We named case those patients who ovulated on the monitored cycle. After applying the exclusion criteria, we consolidated a total of 110 cases and 118 controls. The exposure variables were normal BMI or patients classified with a BMI above normal. Data analysis was performed using SPSS 22.0. Differences in proportions were assessed by X2 test Pearson, Fisher and Wilcoxon test. The value of p<0.05 was considered statistically significant. RESULTS: The groups were comparable in age, age at menarche, number of pregnancies, deliveries, cesarean sections and abortions, number of antral follicles, FSH, prolactin and TSH values. Among the anovulatory patients, 57 (51.82%) were overweight, while among ovulatory patients, 44 (37.29%) were in this same BMI category. The odds ratio was 1.8655, with a significant p value (p<0.05). CONCLUSION: There was an association between anovulation and increase in the Body Mass Index, with an increased risk of anovulation in patients with BMI above normal.

Patients' auto report of regularity of their menstrual cycles. Medical history is very reliable to predict ovulation. A cross-sectional study.

OBJECTIVE: Infertility of ovulatory cause can account for a quarter of infertility etiologies and one of the questions in the patients' clinical history is about their self-perception of the regularity of their menstrual cycles. The aim of this study was to assess whether the information on menstrual regularity is consistent with the assessment of the presence or absence of ovulation. METHODS: Cross-sectional study. The inclusion criteria were: patients with infertility for at least one year, complete examination and ovulation monitoring, aged between 18 and 38 years completed. The patients were divided into two paired groups: those who reported regular menstrual cycles and those who reported irregular cycles. In the ultrasonographic monitoring of ovulation we separated those who ovulated from those who did not ovulate, and applied the Fischer's test. RESULTS: Among the 199 patients who reported having regular menstrual cycles, 113 had proven ovulation upon ultrasound monitoring and 86 patients did not ovulate. Among the 29 patients who reported irregular cycles, 24 did not ovulated at the cycle monitoring. The Fisher's exact test was applied and the p-value found was significant. CONCLUSION: The story of the patient in the clinical interview about the presence of regular or irregular menstruation correlates with the presence or absence of ovulation, it should be taken into consideration in the reasoning regarding the infertility etiology. This report would be important to guide the patient's ovulatory regularity diagnosis.

Há alteração do dia da ovulação em pacientes com sobrepeso ou obesidade? Estudo transversal / Are there change in ovulation day in patients with overweight or obesity? Cross­sectional study

Introdução: A função primordial do ciclo menstrual é promover a capacidade reprodutiva da mulher e alterações nesse ciclo impactam na fertilidade feminina. A obesidade é frequentemente associada a alterações do ciclo menstrual. Objetivo: Avaliar se existe diferença do dia da ovulação entre pacientes com índice de massa corpórea (IMC) normal e aquelas com sobrepeso ou obesidade em pacientes inférteis que não apresentam síndrome de ovários policísticos. Métodos: Estudo transversal feito em ambulatório de reprodução humana. Foram avaliados dois grupos, um com 71 pacientes com IMC normal e outro de 45 pacientes com IMC que indicava sobrepeso/obesidade. Foi analisado a seguir o dia da ovulação das pacientes de cada grupo. As amostras incluíram pacientes de 18 a 38 anos, sem síndrome de ovários policísticos, com as variáveis que pudessem interferir na ovulação pareadas, o que garantia a homogeneidade dos grupos. Resultados: As pacientes com sobrepeso ou obesidade tiveram a ovulação em média no 14,62◦ dia do ciclo e as pacientes com IMC normal em média no 14, 21◦ dia. Não houve significância estatística entre os grupos. Conclusão: Não houve diferença estatística do dia da ovulação entre as pacientes com IMC normal e aquelas com sobrepeso ou obesidade, que não apresentavam outras comorbidades que pusessem afetar a fertilidade.(AU)

Background: The primary function of the menstrual cycle is to promote the reproductive capacity of women and changes in this cycle impact on female fertility. Obesity is often associated with changes in the menstrual cycle. Objective: Assess whether there is difference between ovulation's day in patients with normal BMI and those with overweight or obesity in infertile patients without Polycystic Ovary Syndrome. Methods: Cross-sectional study in Human Reproduction Outpatient Clinic. Two groups, one with 71 patients with normal BMI and the other with 45 patients with a BMI indicating overweight/obesity. It was next analyzed the day of ovulation of patients in each group. The samples included patients 18-38 years without Polycystic Ovary Syndrome, whith the variables that could interfere with ovulation, matched, ensuring the homogeneity of the groups. Results: Patients with overweight or obese had an average ovulation in 14.62◦ day of the cycle, and patients with normal BMI average at 14.21◦ day, with no statistical significance between groups. Conclusion: there was no statistical difference of day of ovulation among patients with normal BMI and those with overweight or obesity, which had no other comorbidities that would put affect fertility.