
==== Front
BMC Womens Health
BMC Womens Health
BMC Women's Health
1472-6874
BioMed Central London

39227849
3335
10.1186/s12905-024-03335-1
Research
Association between a body shape index and female infertility: a cross-sectional study
Yang Qian
Wuliu Jianxiong
Zeng Lingling
Huang Jinfa
Tang Guihua
Zhang Junchao
Liao Kedan kedan1@163.com

Deng Kaixian nsyfek@163.com

https://ror.org/00wwb2b69 grid.460063.7 Department of Gynecology, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, 528308 PR China
4 9 2024
4 9 2024
2024
24 48617 7 2024
26 8 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
Background

The relationship between A Body Shape Index (ABSI) and female infertility is not well understood. ABSI, a novel anthropometric measure, is gaining recognition for its ability to more accurately capture visceral fat characteristics than traditional metrics like BMI. This study aims to explore the association between ABSI and female infertility, considering its potential applications in medical screening and risk assessment.

Methods

This cross-sectional study analyzed data from the NHANES from 2013 to 2020. Female infertility was assessed through reproductive health questionnaires, and ABSI was calculated using waist circumference, BMI, and height. Weighted logistic regression models and trend tests were used to evaluate the association between ABSI and female infertility. Restricted cubic splines (RCS) were employed to explore potential nonlinear relationships. Subgroup analyses were conducted to examine the consistency of the association across various demographic and health-related factors. Sensitivity analyses were also performed, including the exclusion of participants with missing covariate data, the application of propensity score matching, and restricting the analysis to women aged 20–45 years.

Results

The study included 3,718 participants, 433 of whom were diagnosed with infertility. Higher ABSI was associated with an increased risk of female infertility (OR = 1.56, 95% CI: 1.21-2.00, P = 0.001), as demonstrated by weighted logistic regression and trend tests. Women in the highest ABSI quartile had a significantly higher prevalence of infertility compared to those in the lowest quartile (OR = 1.73, 95% CI: 1.27–2.37, P = 0.001). RCS curves indicated a linear positive relationship between ABSI and infertility risk, with a critical value at 0.079. Subgroup and sensitivity analyses confirmed the stability of these findings.

Conclusion

This study demonstrates a positive linear relationship between ABSI and the risk of female infertility. The use of a simple, non-invasive ABSI measurement could facilitate the early identification of high-risk individuals in large-scale screenings, potentially helping to prevent or reduce the incidence of infertility.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-024-03335-1.

Keywords

Infertility
A body shape index
Female reproduction
NHANES
Visceral obesity
The Basic Research and Basic Applied Research Foundation of Guangdong2023A1515140116 The Medical Scientific Research Foundation of Guangdong Province, ChinaA2020527 Shunde Hospital, Southern Medical UniversitySRSP2023021 The Development Center for Medical Science & Technology, National Health Commission of the People’s Republic of ChinaWKZX2024DN0172 issue-copyright-statement© BioMed Central Ltd., part of Springer Nature 2024
==== Body
pmcIntroduction

Infertility is a significant public health issue that affects women’s health and quality of life globally, impacting approximately 10–15% of women of reproductive age [1, 2]. Infertility imposes substantial psychological and emotional stress on women and has profound social and economic implications. The etiology of infertility is multifaceted, involving genetic, environmental, lifestyle, and metabolic factors, which create considerable challenges for effective prevention and treatment [3]. Therefore, identifying new and reliable markers for the prevention and management of infertility is crucial for improving the prognosis and quality of life for affected women.

Obesity has been shown to influence reproductive health through various mechanisms [4]. Specifically, visceral fat is considered more detrimental to reproductive health than subcutaneous fat [5, 6] due to its association with metabolic syndromes such as insulin resistance, hormonal imbalance, and immune dysfunction. These factors collectively impact women’s reproductive health through multiple pathways. Traditional measures like body mass index (BMI) are commonly used to assess obesity; however, they fail to accurately distinguish between visceral and subcutaneous fat [7, 8]. Metrics such as waist-to-hip ratio (WHR) and visceral adiposity index (VAI) are also used to evaluate visceral fat. While these measures address some limitations of BMI, they still have drawbacks. For instance, WHR is not highly precise in assessing visceral fat [9], and VAI, despite incorporating several metabolic parameters, is relatively complex to calculate and has limited applicability in large-scale screenings [10].

A Body Shape Index (ABSI) is a novel anthropometric measure designed to address the limitations of traditional obesity metrics [11]. ABSI is calculated using the formula: ABSI = WC / (BMI^(2/3) * Height^(1/2)). This calculation standardizes waist circumference by accounting for height and weight, providing a more precise estimate of abdominal obesity and visceral fat. Research has demonstrated that ABSI is a robust predictor of cardiovascular disease [12, 13], diabetes [14, 15], cognitive decline [16, 17], metabolic syndrome [18, 19], and mortality [14, 20]. By isolating the effects of central obesity from overall body fat, ABSI is particularly valuable in identifying individuals at high risk for metabolic conditions that BMI might overlook. Additionally, ABSI is straightforward to calculate and non-invasive, making it especially suitable for large-scale epidemiological screenings and clinical settings where rapid and accurate assessments are required. Nevertheless, no studies to date have systematically evaluated the relationship between ABSI and female infertility.

This study aims to utilize data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2020 to assess the relationship between ABSI and female infertility and to explore ABSI’s potential as an independent predictor of infertility. By investigating this relationship, we aim to uncover the potential value of ABSI in assessing infertility risk, aiding healthcare professionals in better identifying and managing women at high risk of infertility, and providing a basis for future research on the relationship between visceral fat and women’s reproductive health.

Methods

Survey description

NHANES is a biennial survey conducted in the United States using a multistage probability sampling design to ensure a nationally representative sample. Data collection involves in-home interviews to gather demographic and health information, along with physical examinations and laboratory tests conducted in mobile examination centers to collect biological samples and clinical data. This study was approved by the Ethics Review Board of the National Center for Health Statistics (NCHS), and informed consent was obtained from all participants.

Study population

The NHANES survey from 2013 to 2020 included 44,960 participants. We excluded 22,173 male participants, 14,525 participants without infertility diagnosis data (those who answered “Refused,” “Don’t know,” or had “Missing” responses were excluded), 297 participants with missing ABSI data, 2,734 participants with missing weight data, and 1,513 participants aged over 50 or under 20. The final sample consisted of 3,718 female participants aged 20–50 years (Fig. 1).

Fig. 1 Inclusion and exclusion criteria flowchart

Infertility assessment

Infertility was assessed during NHANES interviews based on the reproductive health question RHQ074: “Have you ever tried to get pregnant for a year or longer without success?” Participants who answered “yes” were classified as having infertility.

ABSI assessment

In this study, ABSI was the exposure variable. ABSI is calculated using BMI, waist circumference, and height. BMI is derived by dividing weight (kg) by height squared (m²). The formula for calculating ABSI is as follows [21, 22]:

\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\:ABSI=\frac{\text{W}\text{a}\text{i}\text{s}\text{t}\:\text{C}\text{i}\text{r}\text{c}\text{u}\text{m}\text{f}\text{e}\text{r}\text{e}\text{n}\text{c}\text{e}\left(\text{m}\right)\text{}}{\left(BM{I}^{\frac{2}{3}}\right)\ast\:\left(Heigℎt{\left(m\right)}^{\frac{1}{2}}\right)}$$\end{document}

Covariates

The covariates considered in this study included age (recorded in years), poverty-income ratio (PIR), age at menarche (recorded in years), infertility status (yes/no), race (categorized as White, Mexican, Black, and Other), alcohol use (yes/no), education level (less than high school, high school, and above high school), smoking status (yes/no), hypertension (yes/no), diabetes (yes/no), marital status (married, never married, and separated), and pregnancy history (yes/no). These data were collected through standardized questionnaires and interview procedures administered by NHANES. PIR was calculated by dividing household income by the poverty threshold, adjusted for family size [23, 24]. Smoking was defined as having smoked at least 100 cigarettes in a lifetime, and alcohol use was defined as having consumed at least 12 alcoholic drinks in a lifetime. Hypertension and diabetes were determined through self-report. Detailed information on the procedures for obtaining these covariates is available at www.cdc.gov/nchs/nhanes/.

Statistical analysis

To ensure national representativeness, appropriate weighting methods were applied. Baseline characteristics for continuous variables were expressed as means (standard errors), while categorical variables were presented as N (weighted percentage). Multiple imputation was used to address missing covariate data. Weighted logistic regression models were employed to examine the association between ABSI and infertility, with restricted cubic splines (RCS) used to explore potential nonlinear relationships. Subgroup analyses were conducted to evaluate the consistency of the association across various demographic and health-related factors, including race, education, marital status, pregnancy history, smoking status, alcohol use, diabetes, and hypertension. To assess the robustness of the relationship between ABSI and female infertility, three sensitivity analyses were performed. First, the association was re-evaluated using weighted logistic regression after excluding participants with missing covariate data. Second, propensity score matching (PSM) with 1:1 nearest neighbor matching was applied to further assess the significance of the association. Third, the analysis was restricted to participants aged 20–45 years to examine the association within this specific age group. Statistical significance was defined as P < 0.05, and all analyses were conducted using R software.

Results

Characteristics of study population

This study included 3,718 participants, of whom 433 were diagnosed with female infertility. Table 1 presents the weighted baseline characteristics of the study population, stratified by ABSI quartiles. Participants with higher ABSI scores tended to be older and had lower PIR. They also experienced menarche at a later age and had a higher prevalence of infertility. Significant racial differences were observed across ABSI quartiles, with a greater proportion of White and Mexican American women in the highest ABSI quartile. These participants also had lower education levels, lower rates of alcohol consumption, higher smoking rates, and a higher prevalence of hypertension and diabetes. Additionally, participants with higher ABSI scores were more likely to be married and have no history of pregnancy. These findings underscore the substantial differences in demographic, socioeconomic, and health-related variables across different ABSI quartiles.

Table 1 Weighted baseline characteristics of study participants stratified by quartiles of ABSI score

Variables	Q1 (n = 990)	Q2 (n = 961)	Q3 (n = 870)	Q4 (n = 897)	P value	
Age	32.97 (0.42)	34.53 (0.44)	35.48 (0.35)	36.66 (0.32)	< 0.001	
PIR	2.83 (0.09)	2.84 (0.08)	2.87 (0.09)	2.53 (0.08)	0.003	
Menarche	12.44 (0.07)	12.68 (0.07)	12.63 (0.06)	12.65 (0.07)	0.07	
Infertility					< 0.001	
 No	895 (90.70)	860 (89.58)	776 (87.20)	754 (82.45)		
 Yes	95 (9.30)	101 (10.42)	94 (12.80)	143 (17.55)		
Race					< 0.001	
 White	317 (55.33)	318 (58.41)	299 (59.18)	321 (59.15)		
 Mexican	127 (9.25)	158 (10.84)	171 (12.77)	165 (12.47)		
 Black	292 (17.91)	209 (12.98)	150 (10.04)	157 (10.00)		
 Other	254 (17.51)	276 (17.77)	250 (18.00)	254 (18.38)		
Alcohol user					0.02	
 No	149 (11.85)	153 (11.13)	139 (11.34)	184 (15.47)		
 Yes	841 (88.15)	808 (88.87)	731 (88.66)	713 (84.53)		
Education					< 0.001	
 Less high school	118 (8.67)	140 (9.76)	144 (11.74)	202 (17.17)		
 High school	178 (18.63)	176 (17.52)	163 (18.44)	194 (22.20)		
 Above high School	694 (72.70)	645 (72.72)	563 (69.81)	501 (60.63)		
Smoke					< 0.001	
 No	722 (71.67)	690 (69.56)	592 (64.04)	592 (60.19)		
 Yes	268 (28.33)	271 (30.44)	278 (35.96)	305 (39.81)		
Hypertension					< 0.001	
 No	826 (86.25)	819 (87.73)	715 (85.33)	701 (78.00)		
 Yes	164 (13.75)	142 (12.27)	155 (14.67)	196 (22.00)		
Diabetes					< 0.001	
 No	966 (98.24)	932 (97.96)	818 (94.99)	804 (91.88)		
 Yes	24 (1.76)	29 (2.04)	52 (5.01)	93 (8.12)		
Marital status					< 0.001	
 Married	509 (55.77)	557 (60.09)	550 (64.36)	565 (65.59)		
 Never married	353 (33.86)	275 (26.95)	214 (24.47)	200 (20.44)		
 Separated	128 (10.37)	129 (12.96)	106 (11.17)	132 (13.97)		
Pregnancy					< 0.001	
 No	108 (10.01)	119 (14.25)	137 (16.73)	186 (23.36)		
 Yes	882 (89.99)	842 (85.75)	733 (83.27)	711 (76.64)		
ABSI, a body shape index; PIR, poverty-income ratio

Association between ABSI and female infertility

We assessed the relationship between ABSI and female infertility using weighted logistic regression (Table 2). In the fully adjusted model (Model 3), where ABSI was treated as a continuous variable, a significant positive association emerged between ABSI and female infertility (OR = 1.56, 95% CI: 1.21-2.00, P = 0.001). This indicates that higher ABSI is correlated with an increased risk of infertility. Further analysis by ABSI quartiles reinforced this finding, as the highest quartile exhibited a significantly greater prevalence of infertility compared to the lowest quartile (OR = 1.73, 95% CI: 1.27–2.37, P = 0.001). Trend analyses also demonstrated that women with higher ABSI had a significantly elevated risk of infertility (P < 0.001). Moreover, RCS curves depicted a linear positive relationship between ABSI and infertility risk, with a critical threshold at 0.08 (P for overall < 0.001, P for nonlinearity = 0.42) (Fig. 2). Additionally, the RCS curves illustrated a linear positive relationship between ABSI and infertility risk, with a critical value at 0.079 (P for overall < 0.001, P for nonlinearity = 0.42) (Fig. 2).

Table 2 Association between ABSI and female infertility

Exposures	Model 1	Model 2	Model 3	
**ABSI (continuous)	1.80 (1.43,2.28) < 0.001	1.65 (1.29,2.11) < 0.001	1.56 (1.21,2.00) 0.001	
ABSI (quartiles)				
 Q1	ref	ref	ref	
 Q2	1.13 (0.78,1.64) 0.50	1.07 (0.74,1.55) 0.72	1.07 (0.73,1.56) 0.72	
 Q3	1.43 (1.00,2.05) 0.05	1.32 (0.91,1.91) 0.13	1.27 (0.88,1.83) 0.20	
 Q4	2.08 (1.57,2.75) < 0.001	1.86 (1.37,2.51) < 0.001	1.73 (1.27,2.37) 0.001	
P for trend	< 0.001	< 0.001	< 0.001	
Model 1: Non-adjusted

Model 2: Adjusted for age, race, education and PIR

Model 3: Further adjusted for pregnancy, marital status, menarche, smoke, alcohol user, hypertension and diabetes based on model 2

** Continuous variable: ABSI was scaled by a factor of 100, and the OR represents the change in female infertility risk for each 0.01 increase in ABSI

Fig. 2 Non-linear relationship between ABSI and female infertility

Subgroup analysis

In subgroup analyses, we further investigated the influence of various demographic and health-related factors on the association between ABSI and female infertility (Fig. 3). The findings indicated that the positive association between ABSI and female infertility remained consistent across different subgroups, including race, education, marital status, pregnancy history, smoking status, alcohol use, hypertension, and diabetes. However, the interaction effects were not statistically significant. These subgroup analyses underscore the consistency and generalizability of the association between ABSI and female infertility risk across diverse populations.

Fig. 3 Forest plot of stratified analysis and interaction effects for the association between ABSI and female infertility

Sensitivity analysis

To assess the robustness of the association between ABSI and female infertility, we conducted three sensitivity analyses: excluding participants with missing covariate data, applying PSM, and restricting the analysis to women aged 20–45 years. First, after excluding participants with missing covariate data, 3,286 participants remained, including 398 with infertility (Supplementary Table 1). The weighted multivariable regression confirmed a significant association between ABSI and infertility (OR = 1.51, 95% CI: 1.16–1.98, P = 0.004) (Supplementary Table 2). Second, we applied PSM to balance covariates between groups (Supplementary Table 3). Even after matching, women in higher ABSI quartiles continued to show a significantly increased risk of infertility (P < 0.05). Finally, in a subset of women aged 20–45 years, weighted multivariable regression analysis demonstrated that the risk of infertility increased with higher ABSI (OR = 1.82, 95% CI: 1.34–2.48, P < 0.001) (Supplementary Tables 4 and 5). These findings collectively reinforce ABSI as a reliable and independent predictor of infertility risk.

Discussion

This study is the first to investigate the relationship between A Body Shape Index (ABSI) and female infertility using NHANES data. Our results indicate that higher ABSI is associated with an increased risk of female infertility, as demonstrated by weighted multivariable logistic regression analysis and trend tests. The RCS curves reveal a linear positive correlation between ABSI and infertility risk. Subgroup and sensitivity analyses further confirm the robustness of these findings, supporting the potential of ABSI as a risk predictor for female infertility.

Our study is the first to describe the association between ABSI and female infertility, further supporting the link between visceral obesity and an increased risk of infertility. We found that participants with higher ABSI scores exhibited several characteristics, including older age [14, 25], lower poverty-income ratio (PIR) [25, 26], lower education levels [27], higher smoking rates [28, 29], and a higher prevalence of hypertension and diabetes [30–32]. These findings are consistent with other studies on abdominal obesity. Additionally, a higher proportion of White and Mexican American women were in the higher ABSI quartiles, possibly due to racial susceptibility. The literature supports the association between these characteristics and infertility risk, as advanced age [33, 34] and metabolic disorders like hypertension and diabetes [35–37] are recognized as high-risk factors for female infertility. Furthermore, limited access to healthcare, often linked to poverty and low education levels, increases the difficulty in managing infertility, thereby raising the risk [38, 39]. Unhealthy lifestyle choices, such as smoking, are also associated with infertility [40, 41], which our study further corroborates. However, while these risk factors aligned with higher ABSI scores, the relationship between these factors and infertility did not consistently align in our study, particularly with alcohol consumption. This suggests that more complex interactions may need to be considered when interpreting the relationship between ABSI and infertility.

Weighted multivariable logistic regression analysis indicates that high ABSI is an independent risk factor for female infertility, whether ABSI is treated as a continuous variable or divided into quartiles. The RCS analysis reveals a significant positive linear relationship between ABSI and female infertility, with a marked increase in risk when ABSI exceeds 0.079. This threshold is clinically significant, suggesting that early intervention in women with high ABSI may effectively reduce infertility risk. Subgroup and sensitivity analyses further demonstrate the robustness of these results, validating ABSI’s potential as a predictor of infertility risk.

Although several studies have explored the association between visceral obesity and female infertility [5, 6], our research highlights the potential of ABSI as a predictive tool for female infertility and emphasizes its unique clinical application value. Compared to other visceral obesity indices such as VAI, ABSI maintains accuracy while offering non-invasiveness and ease of acquisition, making it particularly suitable for large-scale screening initiatives. Current research indicates that visceral obesity is closely related to various metabolic syndromes and more directly impacts female reproductive health than general obesity, through mechanisms such as insulin resistance, chronic inflammation, and hormonal imbalances [42–44]. Abnormal vascularization of adipose tissue often leads to local hypoxia, triggering insulin resistance—an important mechanism in the development of polycystic ovary syndrome (PCOS) [45–48]. PCOS is one of the most common causes of female infertility [49–51]. In PCOS patients, abnormal fat distribution leads to reduced quality of oocytes and the endometrium, significantly impairing fertility [52, 53]. Insulin resistance may also increase insulin and insulin-like growth factor-1 (IGF-1) levels, which excessively stimulate androgen production, disrupting normal follicle development and ovulation processes [54]. Additionally, the accumulation of visceral fat triggers systemic chronic low-grade inflammation, increasing the release of pro-inflammatory cytokines such as TNF-α and IL-6. These cytokines not only disrupt the microenvironment of the endometrium but also impair ovarian function, ultimately affecting embryo implantation and pregnancy outcomes [55, 56]. Simultaneously, the increase in visceral fat often accompanies elevated estrogen levels, which further disrupt menstrual cycles and ovulation, thereby diminishing fertility [57]. This study provides new evidence supporting the use of ABSI in screening applications for women’s reproductive health, highlighting its potential in the early identification of high-risk individuals. However, further research is needed to fully understand the specific relationship between ABSI and infertility. In particular, there is currently a lack of strong evidence to suggest that weight loss can effectively improve endometrial quality and reproductive outcomes in PCOS patients.

This study has several strengths, including the use of nationally representative samples and the application of multiple statistical methods to validate the robustness of the results. However, there are also limitations. First, the cross-sectional design of the study cannot establish causality between ABSI and female infertility. Second, the diagnosis of infertility in NHANES is based on self-reports rather than a clinical gold standard, which may introduce information and recall biases. Additionally, despite adjusting for multiple covariates, unmeasured confounding factors may still influence the results. Therefore, future research should consider longitudinal designs to further verify the causal relationship between ABSI and female infertility and explore deeper biological mechanisms.

Conclusions

This study demonstrates a significant positive association between ABSI and female infertility, suggesting that ABSI, as a non-invasive indicator of visceral fat, holds potential value in identifying women at high risk for infertility. Incorporating ABSI into large-scale screening programs could aid in the early identification of high-risk individuals, thereby enabling timely interventions that may enhance reproductive outcomes and overall health.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Acknowledgements

The authors gratefully acknowledge all participants and staff of the National Health and Nutrition Examination Survey, along with the National Center for Environmental Health, for their invaluable contributions. Special thanks to Zhang Jing for developing the nhanesR package.

Author contributions

Q. Yang and J.X. Wuliu: Conceptualization, data curation, validation, visualization, and writing – original draft. L.L. Zeng and J.F. Huang: Investigation and validation. G.H. Tang and J.C. Zhang: Validation and visualization. K.D. Liao and K.X. Deng: Supervision, funding acquisition, and writing – review & editing. All authors have reviewed and approved the final manuscript and agreed to the author order.

Funding

This research was funded by the Basic Research and Basic Applied Research Foundation of Guangdong (2023A1515140116); Shunde Hospital, Southern Medical University (SRSP2023021); the Medical Scientific Research Foundation of Guangdong Province, China (No. A2020527); and the Development Center for Medical Science & Technology, National Health Commission of the People’s Republic of China (WKZX2024DN0172).

Data availability

The datasets generated and/or analyzed during this study can be accessed in the NHANES repository at www.cdc.gov/nchs/nhanes.

Declarations

Ethics approval and consent to participate

This study followed the guidelines of the Declaration of Helsinki and received approval from the NCHS Ethics Review Board. All participants provided written informed consent.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Abbreviations

ABSI A Body Shape Index

WHR Waist-to-Hip Ratio

VAI Visceral Adiposity Index

NHANES National Health and Nutrition Examination Survey

RCS Restricted Cubic Splines

BMI Body Mass Index

PIR Poverty Income Ratios

CI Condence Interval

OR Odds Ratio

SE Standard Error

PSM Propensity Score Matching

NCHS National Centre for Health Statistics

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Qian Yang and Jianxiong Wuliu contributed equally to this work.
==== Refs
References

1. Yang C Dong N Li F Ji Y Pan Y She H The cumulative live birth rate of recombinant follicle-stimulating hormone alfa verse urinary human follicle-stimulating hormone for ovarian stimulation in assisted reproductive technology cycles J Ovarian Res 2022 15 74 10.1186/s13048-022-01009-w 35729654
Yang C, Dong N, Li F, Ji Y, Pan Y, She H. The cumulative live birth rate of recombinant follicle-stimulating hormone alfa verse urinary human follicle-stimulating hormone for ovarian stimulation in assisted reproductive technology cycles. J Ovarian Res. 2022;15:74.35729654 10.1186/s13048-022-01009-w
2. Huo P Zhu Y Liang C Yao J Le J Qin L Non-invasive amino acid profiling of embryo culture medium using HPLC correlates with embryo implantation potential in women undergoing in vitro fertilization Front Physiol 2020 11 405 10.3389/fphys.2020.00405 32508665
Huo P, Zhu Y, Liang C, Yao J, Le J, Qin L, et al. Non-invasive amino acid profiling of embryo culture medium using HPLC correlates with embryo implantation potential in women undergoing in vitro fertilization. Front Physiol. 2020;11:405.32508665 10.3389/fphys.2020.00405
3. Wang R Feng Y Chen J Chen Y Ma F Association between polyunsaturated fatty acid intake and infertility among American women aged 20–44 years Front Public Health 2022 10 938343 10.3389/fpubh.2022.938343 36062133
Wang R, Feng Y, Chen J, Chen Y, Ma F. Association between polyunsaturated fatty acid intake and infertility among American women aged 20–44 years. Front Public Health. 2022;10:938343.36062133 10.3389/fpubh.2022.938343
4. Schon SB Cabre HE Redman LM The impact of obesity on reproductive health and metabolism in reproductive-age females Fertil Steril 2024 122 2 194 203 10.1016/j.fertnstert.2024.04.036 38704081
Schon SB, Cabre HE, Redman LM. The impact of obesity on reproductive health and metabolism in reproductive-age females. Fertil Steril. 2024;122(2):194–203.38704081 10.1016/j.fertnstert.2024.04.036
5. Deng C Ke X Lin L Fan Y Li C Association between indicators of visceral lipid accumulation and infertility: a cross-sectional study based on U.S. women Lipids Health Dis 2024 23 186 10.1186/s12944-024-02178-x 38872138
Deng C, Ke X, Lin L, Fan Y, Li C. Association between indicators of visceral lipid accumulation and infertility: a cross-sectional study based on U.S. women. Lipids Health Dis. 2024;23:186.38872138 10.1186/s12944-024-02178-x
6. Zhuang J Wang Y Wang S Hu R Wu Y Association between visceral adiposity index and infertility in reproductive-aged women in the United States Sci Rep 2024 14 14230 10.1038/s41598-024-64849-0 38902300
Zhuang J, Wang Y, Wang S, Hu R, Wu Y. Association between visceral adiposity index and infertility in reproductive-aged women in the United States. Sci Rep. 2024;14:14230.38902300 10.1038/s41598-024-64849-0
7. Song J Chen X Jiang Y Mi J Zhang Y Zhao Y Association and Interaction Analysis of Lipid Accumulation Product with impaired fasting glucose risk: a cross-sectional survey J Diabetes Res 2019 2019 9014698 10.1155/2019/9014698 31772946
Song J, Chen X, Jiang Y, Mi J, Zhang Y, Zhao Y, et al. Association and Interaction Analysis of Lipid Accumulation Product with impaired fasting glucose risk: a cross-sectional survey. J Diabetes Res. 2019;2019:9014698.31772946 10.1155/2019/9014698
8. Zhou J Ren Y Wang C Li L Zhang L Wang B Association of change in waist circumference and dyslipidaemia risk: the rural Chinese cohort study Diabetes Metabolism Res 2018 34 1 e2949 10.1002/dmrr.2949
Zhou J, Ren Y, Wang C, Li L, Zhang L, Wang B, et al. Association of change in waist circumference and dyslipidaemia risk: the rural Chinese cohort study. Diabetes Metabolism Res. 2018;34(1):e2949.10.1002/dmrr.2949
9. Zhao L Zhu C Chen Y Chen C Cheng J Xia F LH/FSH ratio is Associated with visceral adipose dysfunction in Chinese women older than 55 Front Endocrinol (Lausanne) 2018 9 419 10.3389/fendo.2018.00419 30116221
Zhao L, Zhu C, Chen Y, Chen C, Cheng J, Xia F, et al. LH/FSH ratio is Associated with visceral adipose dysfunction in Chinese women older than 55. Front Endocrinol (Lausanne). 2018;9:419.30116221 10.3389/fendo.2018.00419
10. Ratajczak M Skrypnik D Bogdański P Mądry E Walkowiak J Szulińska M Effects of endurance and endurance–strength training on endothelial function in women with obesity: a Randomized Trial Int J Environ Res Public Health 2019 16 21 4291 10.3390/ijerph16214291 31694237
Ratajczak M, Skrypnik D, Bogdański P, Mądry E, Walkowiak J, Szulińska M, et al. Effects of endurance and endurance–strength training on endothelial function in women with obesity: a Randomized Trial. Int J Environ Res Public Health. 2019;16(21):4291.31694237 10.3390/ijerph16214291
11. Leone A Vizzuso S Brambilla P Mameli C Ravella S De Amicis R Evaluation of Different Adiposity Indices and Association with metabolic syndrome risk in obese children: is there a winner? Int J Mol Sci 2020 21 11 4083 10.3390/ijms21114083 32521608
Leone A, Vizzuso S, Brambilla P, Mameli C, Ravella S, De Amicis R, et al. Evaluation of Different Adiposity Indices and Association with metabolic syndrome risk in obese children: is there a winner? Int J Mol Sci. 2020;21(11):4083.32521608 10.3390/ijms21114083
12. Cho HW Chung W Moon S Ryu OH Kim MK Kang JG Effect of Sarcopenia and body shape on Cardiovascular Disease according to obesity phenotypes Diabetes Metab J 2021 45 2 209 18 10.4093/dmj.2019.0223 32662256
Cho HW, Chung W, Moon S, Ryu OH, Kim MK, Kang JG. Effect of Sarcopenia and body shape on Cardiovascular Disease according to obesity phenotypes. Diabetes Metab J. 2021;45(2):209–18.32662256 10.4093/dmj.2019.0223
13. Zhang X Ye R Sun L Liu X Wang S Meng Q Relationship between novel anthropometric indices and the incidence of hypertension in Chinese individuals: a prospective cohort study based on the CHNS from 1993 to 2015 BMC Public Health 2023 23 436 10.1186/s12889-023-15208-7 36879238
Zhang X, Ye R, Sun L, Liu X, Wang S, Meng Q, et al. Relationship between novel anthropometric indices and the incidence of hypertension in Chinese individuals: a prospective cohort study based on the CHNS from 1993 to 2015. BMC Public Health. 2023;23:436.36879238 10.1186/s12889-023-15208-7
14. Qiao YS Tang X Chai YH Gong HJ Zhang X Stehouwer CDA Association of Sarcopenia and a body shape index with overall and cause-specific mortality Front Endocrinol (Lausanne) 2022 13 839074 10.3389/fendo.2022.839074 35865317
Qiao YS, Tang X, Chai YH, Gong HJ, Zhang X, Stehouwer CDA, et al. Association of Sarcopenia and a body shape index with overall and cause-specific mortality. Front Endocrinol (Lausanne). 2022;13:839074.35865317 10.3389/fendo.2022.839074
15. Lee DH Keum N Hu FB Orav EJ Rimm EB Willett WC Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women Eur J Epidemiol 2018 33 11 1113 23 10.1007/s10654-018-0433-5 30117031
Lee DH, Keum N, Hu FB, Orav EJ, Rimm EB, Willett WC, et al. Comparison of the association of predicted fat mass, body mass index, and other obesity indicators with type 2 diabetes risk: two large prospective studies in US men and women. Eur J Epidemiol. 2018;33(11):1113–23.30117031 10.1007/s10654-018-0433-5
16. Li J Sun J Zhang Y Zhang B Zhou L Association between weight-adjusted-waist index and cognitive decline in US elderly participants Front Nutr 2024 11 1390282 10.3389/fnut.2024.1390282 38903624
Li J, Sun J, Zhang Y, Zhang B, Zhou L. Association between weight-adjusted-waist index and cognitive decline in US elderly participants. Front Nutr. 2024;11:1390282.38903624 10.3389/fnut.2024.1390282
17. Zhang Y Zhang P Yin D Association between a body shape index and cognitive impairment among US older adults from a cross-sectional survey of the NHANES 2011–2014 Lipids Health Dis 2024 23 169 10.1186/s12944-024-02165-2 38840158
Zhang Y, Zhang P, Yin D. Association between a body shape index and cognitive impairment among US older adults from a cross-sectional survey of the NHANES 2011–2014. Lipids Health Dis. 2024;23:169.38840158 10.1186/s12944-024-02165-2
18. Nagayama D Watanabe Y Yamaguchi T Suzuki K Saiki A Fujishiro K Issue of Waist circumference for the diagnosis of metabolic syndrome regarding arterial stiffness: possible utility of a body shape index in Middle-aged nonobese Japanese urban residents receiving Health Screening Obes Facts 2022 15 2 160 9 10.1159/000520418 35008086
Nagayama D, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Fujishiro K, et al. Issue of Waist circumference for the diagnosis of metabolic syndrome regarding arterial stiffness: possible utility of a body shape index in Middle-aged nonobese Japanese urban residents receiving Health Screening. Obes Facts. 2022;15(2):160–9.35008086 10.1159/000520418
19. Gradidge PJ Norris SA Crowther NJ The effect of obesity on the Waist circumference cut-point used for the diagnosis of the metabolic syndrome in African women: results from the SWEET study Int J Environ Res Public Health 2022 19 16 10250 10.3390/ijerph191610250 36011884
Gradidge PJ, Norris SA, Crowther NJ. The effect of obesity on the Waist circumference cut-point used for the diagnosis of the metabolic syndrome in African women: results from the SWEET study. Int J Environ Res Public Health. 2022;19(16):10250.36011884 10.3390/ijerph191610250
20. Sun X, Cao L, Liu Y, Huang W, Pei C, Wang X, et al. Sex- and age-specific differences in associations of a body shape index with all-cause and cardiovascular death risks among US adults with diabetes. Nutr Metab Cardiovasc Dis. 2023;33(3):551–559. https://www.nmcd-journal.com/article/S0939-4753(22)00454-9/abstract.
21. Zhang Y Gao W Li B Liu Y Chen K Wang A The association between a body shape index and elevated urinary albumin–creatinine ratio in Chinese community adults Front Endocrinol (Lausanne) 2022 13 955241 10.3389/fendo.2022.955241 35966103
Zhang Y, Gao W, Li B, Liu Y, Chen K, Wang A, et al. The association between a body shape index and elevated urinary albumin–creatinine ratio in Chinese community adults. Front Endocrinol (Lausanne). 2022;13:955241.35966103 10.3389/fendo.2022.955241
22. Gomez-Peralta F Abreu C Cruz-Bravo M Alcarria E Gutierrez-Buey G Krakauer NY Relationship between a body shape index (ABSI) and body composition in obese patients with type 2 diabetes Diabetol Metab Syndr 2018 10 21 10.1186/s13098-018-0323-8 29568333
Gomez-Peralta F, Abreu C, Cruz-Bravo M, Alcarria E, Gutierrez-Buey G, Krakauer NY, et al. Relationship between a body shape index (ABSI) and body composition in obese patients with type 2 diabetes. Diabetol Metab Syndr. 2018;10:21.29568333 10.1186/s13098-018-0323-8
23. Adamczyk M Wender-Ozegowska E Kedzia M Epigenetic factors in Eutopic Endometrium in Women with endometriosis and Infertility Int J Mol Sci 2022 23 7 3804 10.3390/ijms23073804 35409163
Adamczyk M, Wender-Ozegowska E, Kedzia M. Epigenetic factors in Eutopic Endometrium in Women with endometriosis and Infertility. Int J Mol Sci. 2022;23(7):3804.35409163 10.3390/ijms23073804
24. Alves MG Martins AD Cavaco JE Socorro S Oliveira PF Diabetes, insulin-mediated glucose metabolism and Sertoli/blood-testis barrier function Tissue Barriers 2013 1 2 e23992 10.4161/tisb.23992 24665384
Alves MG, Martins AD, Cavaco JE, Socorro S, Oliveira PF. Diabetes, insulin-mediated glucose metabolism and Sertoli/blood-testis barrier function. Tissue Barriers. 2013;1(2):e23992.24665384 10.4161/tisb.23992
25. Tang R Fan Y Luo M Zhang D Xie Z Huang F General and Central Obesity Are Associated with increased severity of the VMS and sexual symptoms of Menopause among Chinese women: a longitudinal study Front Endocrinol (Lausanne) 2022 13 814872 10.3389/fendo.2022.814872 35557846
Tang R, Fan Y, Luo M, Zhang D, Xie Z, Huang F, et al. General and Central Obesity Are Associated with increased severity of the VMS and sexual symptoms of Menopause among Chinese women: a longitudinal study. Front Endocrinol (Lausanne). 2022;13:814872.35557846 10.3389/fendo.2022.814872
26. Zare H Meyerson NS Nwankwo CA Thorpe RJ How Income and Income Inequality Drive depressive symptoms in U.S. adults, does sex matter: 2005–2016 Int J Environ Res Public Health 2022 19 10 6227 10.3390/ijerph19106227 35627767
Zare H, Meyerson NS, Nwankwo CA, Thorpe RJ. How Income and Income Inequality Drive depressive symptoms in U.S. adults, does sex matter: 2005–2016. Int J Environ Res Public Health. 2022;19(10):6227.35627767 10.3390/ijerph19106227
27. Alves RFS Faerstein E Educational inequality in the occurrence of abdominal obesity: Pró-Saúde Study Rev Saude Publica 2015 49 65 10.1590/S0034-8910.2015049005786 26465669
Alves RFS, Faerstein E. Educational inequality in the occurrence of abdominal obesity: Pró-Saúde Study. Rev Saude Publica. 2015;49:65.26465669 10.1590/S0034-8910.2015049005786
28. de Oliveira Fontes Gasperin L Neuberger M Tichy A Moshammer H Cross-sectional association between cigarette smoking and abdominal obesity among Austrian bank employees BMJ Open 2014 4 7 e004899 10.1136/bmjopen-2014-004899 25079922
de Oliveira Fontes Gasperin L, Neuberger M, Tichy A, Moshammer H. Cross-sectional association between cigarette smoking and abdominal obesity among Austrian bank employees. BMJ Open. 2014;4(7):e004899.25079922 10.1136/bmjopen-2014-004899
29. Liu T David SP Tyndale RF Wang H Yu XQ Chen W Relationship between amounts of daily cigarette consumption and abdominal obesity moderated by CYP2A6 genotypes in Chinese Male current smokers Ann Behav Med 2012 43 2 253 61 10.1007/s12160-011-9318-5 22160797
Liu T, David SP, Tyndale RF, Wang H, Yu XQ, Chen W, et al. Relationship between amounts of daily cigarette consumption and abdominal obesity moderated by CYP2A6 genotypes in Chinese Male current smokers. Ann Behav Med. 2012;43(2):253–61.22160797 10.1007/s12160-011-9318-5
30. Bawadi H Abouwatfa M Alsaeed S Kerkadi A Shi Z Body shape index is a stronger predictor of diabetes Nutrients 2019 11 5 1018 10.3390/nu11051018 31067681
Bawadi H, Abouwatfa M, Alsaeed S, Kerkadi A, Shi Z. Body shape index is a stronger predictor of diabetes. Nutrients. 2019;11(5):1018.31067681 10.3390/nu11051018
31. Wang F Chen Y Chang Y Sun G Sun Y New anthropometric indices or old ones: which perform better in estimating cardiovascular risks in Chinese adults BMC Cardiovasc Disord 2018 18 14 10.1186/s12872-018-0754-z 29378513
Wang F, Chen Y, Chang Y, Sun G, Sun Y. New anthropometric indices or old ones: which perform better in estimating cardiovascular risks in Chinese adults. BMC Cardiovasc Disord. 2018;18:14.29378513 10.1186/s12872-018-0754-z
32. Preuss HG Bean Amylase inhibitor and other Carbohydrate absorption blockers: effects on Diabesity and General Health J Am Coll Nutr 2009 28 3 266 76 10.1080/07315724.2009.10719781 20150600
Preuss HG. Bean Amylase inhibitor and other Carbohydrate absorption blockers: effects on Diabesity and General Health. J Am Coll Nutr. 2009;28(3):266–76.20150600 10.1080/07315724.2009.10719781
33. Farnezi HCM Goulart ACX dos Santos A Ramos MG Penna MLF Three-parent babies: mitochondrial replacement therapies JBRA Assist Reprod 2020 24 2 189 96 32073245
Farnezi HCM, Goulart ACX, dos Santos A, Ramos MG, Penna MLF. Three-parent babies: mitochondrial replacement therapies. JBRA Assist Reprod. 2020;24(2):189–96.32073245
34. Langarizadeh M Nadjarzadeh A Maghsoudi B Fatemi Aghda SA The nutritional content required to design an educational application for infertile women BMC Womens Health 2023 23 22 10.1186/s12905-023-02156-y 36650480
Langarizadeh M, Nadjarzadeh A, Maghsoudi B, Fatemi Aghda SA. The nutritional content required to design an educational application for infertile women. BMC Womens Health. 2023;23:22.36650480 10.1186/s12905-023-02156-y
35. Skåra KH Hernáez Á Næss Ø Fraser A Lawlor DA Burgess S Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample mendelian randomization analyses in the Trøndelag Health Study Hum Reprod Open 2024 2024 3 hoae033 10.1093/hropen/hoae033 38911051
Skåra KH, Hernáez Á, Næss Ø, Fraser A, Lawlor DA, Burgess S, et al. Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample mendelian randomization analyses in the Trøndelag Health Study. Hum Reprod Open. 2024;2024(3):hoae033.38911051 10.1093/hropen/hoae033
36. Zaimi M Michalopoulou O Stefanaki K Kazakou P Vasileiou V Psaltopoulou T Gonadal dysfunction in women with diabetes mellitus Endocrine 2024 85 2 461 72 10.1007/s12020-024-03729-z 38353886
Zaimi M, Michalopoulou O, Stefanaki K, Kazakou P, Vasileiou V, Psaltopoulou T, et al. Gonadal dysfunction in women with diabetes mellitus. Endocrine. 2024;85(2):461–72.38353886 10.1007/s12020-024-03729-z
37. Lei R Chen S Li W Advances in the study of the correlation between insulin resistance and infertility Front Endocrinol (Lausanne) 2024 15 1288326 10.3389/fendo.2024.1288326 38348417
Lei R, Chen S, Li W. Advances in the study of the correlation between insulin resistance and infertility. Front Endocrinol (Lausanne). 2024;15:1288326.38348417 10.3389/fendo.2024.1288326
38. Thakker S Persily J Voigt P Blakemore J Licciardi F Najari BB Evaluating the unevaluated: a secondary analysis of the National Survey for Family Growth (NSFG) examining infertile women who did not access care J Assist Reprod Genet 2021 38 5 1071 6 10.1007/s10815-021-02149-6 33745082
Thakker S, Persily J, Voigt P, Blakemore J, Licciardi F, Najari BB. Evaluating the unevaluated: a secondary analysis of the National Survey for Family Growth (NSFG) examining infertile women who did not access care. J Assist Reprod Genet. 2021;38(5):1071–6.33745082 10.1007/s10815-021-02149-6
39. Nyamhanga T Frumence G Simba D Prevention of mother to child transmission of HIV in Tanzania: assessing gender mainstreaming on paper and in practice Health Policy Plan 2017 32 Suppl 5 v22 30 10.1093/heapol/czx080 28985429
Nyamhanga T, Frumence G, Simba D. Prevention of mother to child transmission of HIV in Tanzania: assessing gender mainstreaming on paper and in practice. Health Policy Plan. 2017;32(Suppl 5):v22–30.28985429 10.1093/heapol/czx080
40. Park SR Kim SK Kim SR Yu WJ Lee SJ Lee HY Effects of smoking on the tissue regeneration-associated functions of human endometrial stem cells via a novel target gene SERPINB2 Stem Cell Res Ther 2022 13 404 10.1186/s13287-022-03061-1 35932085
Park SR, Kim SK, Kim SR, Yu WJ, Lee SJ, Lee HY. Effects of smoking on the tissue regeneration-associated functions of human endometrial stem cells via a novel target gene SERPINB2. Stem Cell Res Ther. 2022;13:404.35932085 10.1186/s13287-022-03061-1
41. Grodstein F Goldman MB Cramer DW Infertility in women and moderate alcohol use Am J Public Health 1994 84 9 1429 32 10.2105/AJPH.84.9.1429 8092366
Grodstein F, Goldman MB, Cramer DW. Infertility in women and moderate alcohol use. Am J Public Health. 1994;84(9):1429–32.8092366 10.2105/AJPH.84.9.1429
42. Diamanti-Kandarakis E Role of obesity and adiposity in polycystic ovary syndrome Int J Obes 2007 31 2 S8 13 10.1038/sj.ijo.0803730
Diamanti-Kandarakis E. Role of obesity and adiposity in polycystic ovary syndrome. Int J Obes. 2007;31(2):S8–13.10.1038/sj.ijo.0803730
43. Sato F Nishi M Kudo R Miyake H Body Fat distribution and Uterine Leiomyomas J Epidemiol 1998 8 3 176 80 10.2188/jea.8.176 9782674
Sato F, Nishi M, Kudo R, Miyake H. Body Fat distribution and Uterine Leiomyomas. J Epidemiol. 1998;8(3):176–80.9782674 10.2188/jea.8.176
44. Venkatesh SS Ferreira T Benonisdottir S Rahmioglu N Becker CM Granne I Obesity and risk of female reproductive conditions: a mendelian randomisation study PLoS Med 2022 19 2 e1003679 10.1371/journal.pmed.1003679 35104295
Venkatesh SS, Ferreira T, Benonisdottir S, Rahmioglu N, Becker CM, Granne I, et al. Obesity and risk of female reproductive conditions: a mendelian randomisation study. PLoS Med. 2022;19(2):e1003679.35104295 10.1371/journal.pmed.1003679
45. Cifarelli V, Beeman SC, Smith GI, Yoshino J, Morozov D, Beals JW et al. Decreased adipose tissue oxygenation associates with insulin resistance in individuals with obesity. J Clin Invest 130(12):6688–99.
46. Bednarz K Kowalczyk K Cwynar M Czapla D Czarkowski W Kmita D The role of Glp-1 receptor agonists in insulin resistance with concomitant obesity treatment in polycystic ovary syndrome Int J Mol Sci 2022 23 8 4334 10.3390/ijms23084334 35457152
Bednarz K, Kowalczyk K, Cwynar M, Czapla D, Czarkowski W, Kmita D, et al. The role of Glp-1 receptor agonists in insulin resistance with concomitant obesity treatment in polycystic ovary syndrome. Int J Mol Sci. 2022;23(8):4334.35457152 10.3390/ijms23084334
47. Escobar-Morreale HF Martínez-García MÁ Insenser M Cañellas N Correig X Luque-Ramírez M Serum metabolomics profiling by Proton nuclear magnetic resonance spectroscopy reveals sexual dimorphism and masculinization of intermediate metabolism in women with polycystic ovary syndrome (PCOS) Biol Sex Differ 2023 14 21 10.1186/s13293-023-00507-w 37076926
Escobar-Morreale HF, Martínez-García MÁ, Insenser M, Cañellas N, Correig X, Luque-Ramírez M. Serum metabolomics profiling by Proton nuclear magnetic resonance spectroscopy reveals sexual dimorphism and masculinization of intermediate metabolism in women with polycystic ovary syndrome (PCOS). Biol Sex Differ. 2023;14:21.37076926 10.1186/s13293-023-00507-w
48. Ramanjaneya M Jerobin J Bettahi I Bensila M Aye M Siveen KS Lipids and insulin regulate mitochondrial-derived peptide (MOTS‐c) in PCOS and healthy subjects Clin Endocrinol 2019 91 2 278 87 10.1111/cen.14007
Ramanjaneya M, Jerobin J, Bettahi I, Bensila M, Aye M, Siveen KS, et al. Lipids and insulin regulate mitochondrial-derived peptide (MOTS‐c) in PCOS and healthy subjects. Clin Endocrinol. 2019;91(2):278–87.10.1111/cen.14007
49. Bourgneuf C Bailbé D Lamazière A Dupont C Moldes M Farabos D The Goto-Kakizaki rat is a spontaneous prototypical rodent model of polycystic ovary syndrome Nat Commun 2021 12 1064 10.1038/s41467-021-21308-y 33594056
Bourgneuf C, Bailbé D, Lamazière A, Dupont C, Moldes M, Farabos D, et al. The Goto-Kakizaki rat is a spontaneous prototypical rodent model of polycystic ovary syndrome. Nat Commun. 2021;12:1064.33594056 10.1038/s41467-021-21308-y
50. Ezzat RS Abdallah W Elsayed M Saleh HS Abdalla W Impact of bariatric surgery on androgen profile and ovarian volume in obese polycystic ovary syndrome patients with infertility Saudi J Biol Sci 2021 28 9 5048 52 10.1016/j.sjbs.2021.05.022 34466081
Ezzat RS, Abdallah W, Elsayed M, Saleh HS, Abdalla W. Impact of bariatric surgery on androgen profile and ovarian volume in obese polycystic ovary syndrome patients with infertility. Saudi J Biol Sci. 2021;28(9):5048–52.34466081 10.1016/j.sjbs.2021.05.022
51. Palomba S Is fertility reduced in ovulatory women with polycystic ovary syndrome? An opinion paper Hum Reprod 2021 36 9 2421 8 10.1093/humrep/deab181 34333641
Palomba S. Is fertility reduced in ovulatory women with polycystic ovary syndrome? An opinion paper. Hum Reprod. 2021;36(9):2421–8.34333641 10.1093/humrep/deab181
52. Palomba S Piltonen TT Giudice LC Endometrial function in women with polycystic ovary syndrome: a comprehensive review Hum Reprod Update 2021 27 3 584 618 10.1093/humupd/dmaa051 33302299
Palomba S, Piltonen TT, Giudice LC. Endometrial function in women with polycystic ovary syndrome: a comprehensive review. Hum Reprod Update. 2021;27(3):584–618.33302299 10.1093/humupd/dmaa051
53. Palomba S Daolio J La Sala GB Oocyte competence in women with polycystic ovary syndrome Trends Endocrinol Metabolism 2017 28 3 186 98 10.1016/j.tem.2016.11.008
Palomba S, Daolio J, La Sala GB. Oocyte competence in women with polycystic ovary syndrome. Trends Endocrinol Metabolism. 2017;28(3):186–98.10.1016/j.tem.2016.11.008
54. Xing C Zhao H Zhang J He B Effect of metformin versus metformin plus liraglutide on gonadal and metabolic profiles in overweight patients with polycystic ovary syndrome Front Endocrinol (Lausanne) 2022 13 945609 10.3389/fendo.2022.945609 36060969
Xing C, Zhao H, Zhang J, He B. Effect of metformin versus metformin plus liraglutide on gonadal and metabolic profiles in overweight patients with polycystic ovary syndrome. Front Endocrinol (Lausanne). 2022;13:945609.36060969 10.3389/fendo.2022.945609
55. Nair S Nguyen H Salama S Al-Hendy A Obesity and the Endometrium: Adipocyte-secreted proinflammatory TNFα cytokine enhances the proliferation of human endometrial glandular cells Obstet Gynecol Int 2013 2013 368543 10.1155/2013/368543 24288542
Nair S, Nguyen H, Salama S, Al-Hendy A. Obesity and the Endometrium: Adipocyte-secreted proinflammatory TNFα cytokine enhances the proliferation of human endometrial glandular cells. Obstet Gynecol Int. 2013;2013:368543.24288542 10.1155/2013/368543
56. Yildirim G Attar R Ficicioglu C Karateke A Ozkan F Yesildaglar N Etanercept causes regression of endometriotic implants in a rat model Arch Gynecol Obstet 2010 283 6 1297 302 10.1007/s00404-010-1543-9 20544212
Yildirim G, Attar R, Ficicioglu C, Karateke A, Ozkan F, Yesildaglar N. Etanercept causes regression of endometriotic implants in a rat model. Arch Gynecol Obstet. 2010;283(6):1297–302.20544212 10.1007/s00404-010-1543-9
57. Pérez-Martín AR Castro-Eguiluz D Cetina-Pérez L Velasco-Torres Y Bahena-González A Montes-Servín E Impact of metabolic syndrome on the risk of endometrial cancer and the role of lifestyle in prevention Bosn J Basic Med Sci 2022 22 4 499 510 35276057
Pérez-Martín AR, Castro-Eguiluz D, Cetina-Pérez L, Velasco-Torres Y, Bahena-González A, Montes-Servín E, et al. Impact of metabolic syndrome on the risk of endometrial cancer and the role of lifestyle in prevention. Bosn J Basic Med Sci. 2022;22(4):499–510.35276057
