Sains Malaysiana 52(12)(2023): 3475-3484

http://doi.org/10.17576/jsm-2023-5212-10

Relationship between Obesity and Infertility among Women with Polycystic Ovarian Syndrome Treated at the National Population and Family Development Board (NPFDB) Malaysia

(Hubungan antara Keobesitian dan Ketidaksuburan dalam Kalangan Wanita dengan Sindrom Ovari Polisistik Dirawat di Lembaga Penduduk dan Pembangunan Keluarga Negara (LPPKN) Malaysia)

HASNOORINA HUSIN^1,2, MOHD AZIZUDDIN MOHD YUSSOF¹, ASMAH HAMID², ISMARULYUSDA ISHAK² & SITI BALKIS BUDIN^3,*

¹Biomedical Unit, Division of Human Reproductive, National Population and Family Development Board, 12B, Jalan Raja Laut, 50350 Kuala Lumpur, Malaysia

²Center for Toxicology and Health Risk, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia

³Center for Diagnostic^, Therapeutic and Investigative^, Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz,

50300 Kuala Lumpur, Malaysia

Diserahkan: 8 Disember 2023/Diterima: 18 Disember 2023

Abstract

Polycystic ovarian syndrome (PCOS) is a metabolic dysfunction and is closely related to infertility in women. Obesity has an impact on the clinical manifestations of PCOS. This study was designed to determine the relationship between obesity and infertility among women with PCOS treated at the National Population and Family Development Board (NPFDB) Malaysia. This is a cross-sectional study with a simple random sampling technique involving infertile women attending NPFDB Subfertility Clinic, Kuala Lumpur, Malaysia, from January 2018 to December 2019. Clinical and menstrual history were recorded, and subjects underwent physical examination by a medical doctor. Subjects were diagnosed with PCOS based on Rotterdam criteria, and blood was taken for reproductive hormone, blood glucose, cholesterol, and triglyceride determination. A total of 179 infertile women completed the study, and 84 (47%) were diagnosed with PCOS. Results showed a significant increase in follicle-stimulating hormone (FSH) levels along with a significant reduction in progesterone level (p<0.05) in PCOS women compared to non-PCOS women. A total of 44% of PCOS women were found to be obese, and they exhibited significantly higher blood pressure and triglyceride level but lower high-density lipoprotein (HDL) level (p<0.05). Chi-square (χ2) showed PCOS women who are obese are more likely to experience ovulatory dysfunction, as evidenced by oligo- and amenorrhea, compared to non-obese women with PCOS. In addition, they were also presented with significantly higher testosterone levels (p<0.05) and reduced progesterone levels compared to non-obese PCOS women. This study showed that PCOS women with obesity had more prominent ovulatory dysfunction and reproductive hormonal imbalance than non-obese PCOS women. These findings suggest that PCOS women with obesity are more prone to develop infertility.

Keywords: Infertility; obesity; polycystic ovarian syndrome

Abstrak

Sindrom ovari polisistik (PCOS) adalah disfungsi metabolik dan berkait rapat dengan ketidaksuburan pada wanita. Keobesitian pula mempunyai kesan ke atas manifestasi klinikal PCOS. Kajian ini direka untuk menentukan hubungan antara keobesitian dan ketidaksuburan dalam kalangan wanita dengan PCOS yang dirawat di Lembaga Penduduk dan Pembangunan Keluarga Negara (LPPKN) di Malaysia. Kajian ini merupakan kajian keratan rentas dengan teknik persampelan rawak mudah melibatkan wanita tidak subur yang menghadiri Klinik Subfertiliti di LPPKN, Kuala Lumpur, Malaysia dari Januari 2018 hingga Disember 2019. Sejarah klinikal dan haid direkodkan dan subjek menjalani pemeriksaan fizikal oleh doktor perubatan. Subjek didiagnosi menghidap PCOS berdasarkan kriteria Rotterdam dan darah diambil untuk penentuan aras hormon reproduktif, glukosa, trigliserida dan kolesterol. Seramai 179 orang wanita tidak subur menyelesaikan kajian ini dan 84 (47%) daripadanya telah didiagnosis mengalami PCOS. Hasil kajian mendapati hormon perangsang folikel (FSH) adalah lebih tinggi dan progesteron adalah lebih rendah dengan ketara (p<0.05) pada wanita PCOS berbanding wanita tanpa PCOS. Seramai 44% wanita PCOS didapati obes dan mempunyai tekanan darah dan trigliserida yang lebih tinggi serta aras lipoprotein berketumpatan tinggi (HDL) lebih rendah dengan ketara (p<0.05). Khi kuasa dua (χ2) menunjukkan wanita PCOS yang mengalami obesiti mengalami disfungsi ovulasi yang ketara yang ditunjukkan oleh oligo dan amenorea berbanding wanita PCOS bukan obes. Tambahan pula, tahap testosteron adalah lebih tinggi secara signifikan (p<0.05) dan progesteron lebih rendah pada wanita PCOS yang obes. Sebagai kesimpulan kajian ini mendedahkan bahawa wanita PCOS dengan obesiti mempunyai disfungsi ovulasi dan ketidakseimbangan hormon reproduktif yang lebih ketara berbanding wanita PCOS bukan obes. Penemuan ini menunjukkan bahawa wanita PCOS dengan obesiti lebih cenderung untuk mengalami ketidaksuburan.

Kata kunci: Kobesitian; ketidaksuburan; sindrom ovari polisistik

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*Pengarang untuk surat-menyurat; email: balkis@ukm.edu.my