3.6.2Low body weight and female fertility

StudyPopulationInterventionOutcomesResultsCommentsStudy typeEL
Wentz 19809224 women with primary and secondary amenorrhoeaEstimated % of body fat lossLoss of over 30% body fatOther outcomes includedDE3
Knuth et al. 19779339 women with amenorrhoea due to loss of weight: 24 with anorexia nervosa, 15 undiagnosedEncouraged to put on weightWeight gain

Ovulation resumption
Significant mean weight gain of 3.6 kg exceeding weight at baseline

14/39 (36%) resumed ovulation
Bates et al. 19829447 women with simple weight loss:

Group A: 29 with unexplained infertility
Group B: 18 (4 diagnosed with anorexia nervosa) with menstrual dysfunction
Dietitian-instructed weight gaining regimeWeight gain

Absence of menstrual cycle

Pregnancy rates
Mean weight gain:

Group A: 8.2 lb (SD 0.8)
Group B: 9.8 lb (SD 1.3)

Menstrual cycle:

Group A: pre-regimen 3/29 (10%); post-regimen 0/26 (0%)
Group B: pre-regimen 16/18 (89%); post-regimen 1/10 (10%)

Pregnancy rates:

Group A only: 19/26 (73%)
Dropout rates:

Group A 3/29 (10%)
Group B 8/18 (44%)

Other outcomes included:

Simple weight loss: 85–95% of ideal body weight
Severe weight loss: < 85% of ideal body weight

From: Evidence tables

Cover of Fertility
Fertility: Assessment and Treatment for People with Fertility Problems.
NICE Clinical Guidelines, No. 11.
National Collaborating Centre for Women's and Children's Health (UK).
London (UK): RCOG Press; 2004 Feb.
Copyright © 2004, National Collaborating Centre for Women’s and Children’s Health.

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