Perfil ovulatório ultrassonográfico em pacientes com excesso de peso em reprodução humana

• Ano de defesa: 2017
• Autor(a) principal: Sasaki, Reinaldo Satoru Azevedo
• Orientador(a): Approbato, Mário Silva
• Banca de defesa: Approbato, Mário Silva, Ferreira, Rui Gilberto, Lima , Yanna Andressa Ramos de, Moraes , Vardeli Alves de, Maia , Mônica Canêdo Silva
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Goiás
• Programa de Pós-Graduação: Programa de Pós-graduação em Ciências da Saúde (FM)
• Departamento: Faculdade de Medicina - FM (RG)
• País: Brasil
• Palavras-chave em Português: Ovulação; Detecção da ovulação; Ultrassonografia; Sobrepeso; Obesidade
• Palavras-chave em Inglês: Ovulation; Ovulation detection; Ultrasonography; Overweight; Obesity
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://repositorio.bc.ufg.br/tede/handle/tede/7141

Background: Obesity affects the hypothalamus-pituitary-ovarian axis, and thus ovulation and menstrual cycle. As ovarian function is closely related to endocrine physiology, the ovulation association study with the body mass index will help to quantify the chance of anovulation in overweight patients. Objective: To evaluate the association between anovulation in the ultrasonographic monitoring and changes of weight of infertile patients without polycystic ovary of infertility's ambulatory of a university, where the outcome's factors were anovulation present or absent, and exposure factors: BMI nomal or above normal. Methods: Case-control study with 228 patients treated at a university in the city of Goiânia, divided into two groups according to the absence (group 1, cases = 110) or the presence of ovulation (group 2, control = 119) and assessed for normal body weight or above normal. Data analysis was performed using SPSS 22.0. Differences in proportions were assessed by Pearson's chi-square test (with Fisher correction where necessary) and Wilcoxon test. The value of p <0.05 was considered statistically significant. Among the patient groups were matched the average of the variables: age (1 = 32.45 years ± 4.13; 2 = 32.66 years ± 3.95), menarche (1 = 12.56 years ± 1.75; 2 = 12.61 years ± 1.6), FSH (6,11UI/L ± 1.98; 2 = 5.92 IU/L ± 1.61), prolactin (1 = 12.17 mcg/L ± 4.04; 2 = 12.09 mcg/L ± 3.98), TSH (1 = 1,824 mIU/L ± 0.749; 2 = 1.775 mU/L ± 0.844). Results: The anovulatory patients were likely to have irregular cycles 6.3 times more than the ovulatory patients. Among the ovulatory patients, those overweight had an average ovulation in 14.62° day of the cycle, and patients with normal BMI at 14.21°, with no statistical significance. The maximum mean follicular diameter reached before ovulation was 18.62 mm in patients with overweight. Among those with normal BMI, the average was 19.10 mm, with no statistical difference. In the group of anovulatory patients, the mean BMI was 25.64 kg/m² ± 4.24, and in the ovulatory patients, the mean BMI was 24.76 kg/m² ± 3.81. Among the anovulatory patients, 57 were overweight, while among ovulatory patients, 44 were in this same category of BMI. The odds ratio was 1.8655, with significant p value (p <0.05). Conclusion: There was association of anovulation with BMI above normal. Among the patients who ovulated, there was no association of the day of ovulation and maximum follicle diameter with BMI. There was association of anovulation with the report of irregularity of the cycle.