The correlation between Anthropometry and infertility in women

Infertility owing to obesity and overweight is a serious problem in Ghana now, affecting a large number of women because of the impact of foreign lifestyles on our societies. Excess weight is not only linked to increased risk of chronic disease and life threatening comorbidities such as diabetes, hypertension and dyslipidemia but has also been shown to increase risk of reproductive problems. A descriptive study was carried out to investigate the correlation between anthropometrics and infertility in women. This study was aimed at investigating the correlation between anthropometric indices such as Body mass index (BMI), waist to hip ratio (WHR) and waist circumference (WC) and infertility in women. In all, one hundred and forty four (144) women (32.5 ± 12.5 years, range 20-45yrs) visiting the Department of Obstetrics and Gynaecology at the Komfo Anokye Teaching Hospital for infertility issues were randomly recruited into the study by a single qualified Obstetrician and Gynaecologist. Ethical clearance was received from Committee on Human Research, Publications and Ethics (CHRPE), School of Medical Sciences, Kwame Nkrumah University of Science & Technology (KNUST), Kumasi. All subjects gave informed consent to take part in the study after verbal and written explanation of the methods and risks involved had been given. Anthropometric measurements (BMI, WHR, HC, and WC) were carried out by qualified personnel using standardized methods and procedures. Venous blood samples were taken for the biochemical assays (Blood Glucose, Total Cholesterol, Triglycerides, HDL-Cholesterol, LDL-Cholesterol and VLDL. Other Hormonal assays including, 21-day Progesterone, Prolactin, Follicle Stimulating Hormone and Luteinizing Hormone were analyzed. According to classifications by BMI, the subjects were categorized into four groups; Normal (BMI 18.5-25 kg/m2), Overweight (BMI 25-30 kg/m2), Obese I (BMI 30-35 kg/m2) and Obese II (BMI 35-40 kg/m2). The mean BMI was 28.92±4.88. With regards to WHR, the subjects were categorized into three groups; Group I (WHR 0.80 or below) were subjects with Low risk of developing cardiovascular disease (CVD), Group II (WHR 0.81-0.85) were subjects with moderate risk of developing CVD and Group III (WHR > 0.85) were subjects with high risk of developing cardiovascular disease. The mean WC measurement for the subjects was 87.92±10.10. There was significant correlation between most of the anthropometric indices. The correlation coefficients noticed between BMI, WHR, WC, HC and Weight was very significant (p<0.0001). The prevalence of overweight and obesity (using BMI) among the infertile women in this study was 34.72 and 45.14% respectively. Again, using WHR, more of the infertile women were obese with prevalence of 54.17%. The most prevalent duration of infertility in the study was between 1 to 5 years with majority of the subjects (about 62.5% of the total population) in the overweight and obese groups. The longest duration of infertility in the study was between 21 to 25 years. Approximately 28.5, 17.36, 14.6, 9.7, 9.7, 7.02, 6.9 and 4.2% of the participants had the following infertility condition(s) respectively: Tubal factors, Male Factors, Ovulation problems, Unexplained Causes, Uterine problems, Hyperprolactinaemia, PCOS and Endometriosis. Overweight and obesity was highest among the Akans (63.89%), least among the Northerners (7.64%), Ewes (4.17%) and the Gas (4.17%). There was significant positive correlation between fasting blood glucose (FBS) (p<0.0028), total cholesterol (T-chol) (p<0.0003), triglycerides (p<0.0014), LDL-cholesterol (p<0.0001) and the Obese II group. This is evident of high prevalence of dysmetabolism such as diabetes, cardiovascular risk factors and dyslipidemia with increasing body weight gains among the infertile women. There was no strong correlation between BMI and the hormonal profiles of the infertile women. Altogether the findings of this study have revealed for purposes of this study, that BMI is a more reliable predictor of dysmetabolism such as diabetes, dyslipidemia and cardiovascular risk factors compared to WHR. Tubal factor infertility was the most prevalent cause of infertility, followed by male factors whereas endometriosis was the least prevalent cause of infertility in the study. This is in agreement with other studies conducted on infertile women, and especially those studies conducted in Africa. Women with excess body weight are more likely to have fertility problems and therefore weight reducing therapies such as exercises and dietary interventions must be incorporated into the treatment of infertility.

Source: KNUST