title: [Infertility: A key time to follow a medical nutritional management. Our experience on 78 patients].
abstract: OBJECTIVE
  The prevalence of female obesity is increasing. Obesity leads to increased infertility and difficulties in the management of Assisted Reproductive Technology (ART). A specialized nutritional consultation was created in 2008 at University Hospital of Lille, to support infertile obese and overweight patients and to achieve a BMI below 35kg/m(2) before pregnancy. The aim of this retrospective study was to evaluate our practice of nutritional support on weight and pregnancy rate.
  
  
  METHODS
  Seventy-eight obese or overweight patients, followed in nutrition and ART for at least two years, were compared to a control group of 119 normal weight patients. The nutritional strategy was mainly based on lifestyle changes, to establish healthier food and higher physical activity.
  
  
  RESULTS
  The mean initial BMI was 37.5kg/m(2) vs 35.6kg/m(2) after nutritional support (significant weight loss, [P<0.001]). Obese or overweight patients had more frequently metabolic syndrome (P<0.01). The chances of pregnancy, after weight loss, were similar to the control group both in IUI and IVF/ICSI. However, gonadotropin doses were increased in the obese and overweight group (P=0.007). The hypocaloric diet was the most effective nutritional strategy to achieve a weight loss greater than 5% of initial weight (P=0.017). Regular physical activity practice allowed also more frequently to achieve this goal (P=0.074). Even after weight loss, a significant number of gestational diabetes (25% of pregnancies in our population) occurred in the obese or overweight group.
  
  
  CONCLUSIONS
  This nutritional consultation promotes weight loss in infertile obese or overweight patients. The maternity desire is a strong motivational lever to weight loss, which leads to satisfying pregnancy rate.
authors.affiliation: Service d'orthogénie et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France. Electronic address: claire.parent@hotmail.fr.
authors.forename: C
authors.initials: C
authors.lastname: Parent
authors.affiliation: Service de nutrition, hôpital Huriez, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Pigeyre
authors.affiliation: Service de nutrition, hôpital Huriez, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Pleuvret
authors.affiliation: Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.affiliation: Service de pathologie maternelle et fœtale, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
authors.forename: P
authors.initials: P
authors.lastname: Deruelle
authors.affiliation: Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Dewailly
authors.affiliation: Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille, France.
authors.forename: S
authors.initials: S
authors.lastname: Catteau-Jonard
mesh_terms: D000328:Adult; D015992:Body Mass Index; D031204:Caloric Restriction; D016640:Diabetes, Gestational / Q000453:epidemiology; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000178:diet therapy* / Q000453:epidemiology; D024821:Metabolic Syndrome / Q000150:complications; D044623:Nutrition Therapy / Q000379:methods*; D009765:Obesity / Q000150:complications* / Q000178:diet therapy; D050177:Overweight / Q000150:complications* / Q000178:diet therapy; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D015431:Weight Loss
keywords: Amaigrissement; Grossesse; Infertility; Infertilité; Nutrition; Obesity; Obésité; Overweight; Pregnancy; Surpoids; Weight loss