IMPROVING REPRODUCTIVE PHYSIOLOGY AND FERTILITY FOR PEOPLE WITH ABNORMAL BODY MASS INDEX

Susan Arentz, Gemma M. O'Brien, School of Biological, Biomedical and Molecular Sciences, University of New England, NSW 2351.

Do improvements in bodyweight cause improvements in reproductive physiology and fertility?

Women undergoing a preconception health program were assessed for Body Mass Index (BMI) and allocated to the control group (n=31) if their BMI was in the normal range (19-24 kg/m²) or the test group if not (n=17). BMI and reproductive physiology were measured before and after the four-month program and conception rates are currently being monitoring. The program involved individually tailored combinations of medical and naturopathic treatments.

Reproductive physiology was evaluated using nine signs and symptoms of the menstrual cycle. Pre-treatment data consisted of symptoms assessed from detailed histories using questionnaire and interview; a prospectively recorded symptom diary assisted post-treatment data collection. Data collected for menstrual symptoms were converted to ordinal level using scores that ranged from zero for parameters in the normal range to a score of 8 for parameters severely above or below normal. The cumulative score for menstrual symptoms was subjected to Kruskal-Wallis rank sum tests for comparison of pre- and post-treatment scores.

Following treatment, 16 women (of 17) in the test group moved towards the healthy BMI range, with 8 moving into the normal range. Patients in both groups improved their reproductive physiology (treatment p<0.01); there was no difference between the groups after the program (post treatment, between groups p> 0.1).

To date there have been 10 pregnancies in the control group (32%) and 7 amongst the test group (41%). Conceptions in the test group included 4 patients who had initially been underweight or overweight, and had moved into the optimum BMI range.

While the data are preliminary, it appears that patients with abnormal BMI can improve their reproductive physiology and fertility with a pre-conception health program, and that the benefits may be available to couples even if they cannot achieve normal range BMI immediately.