La transferencia diferida del embrión aumenta las probabilidades de embarazo en mujeres con obesidad

La transferencia en un ciclo posterior al de la estimulación ovocitaria aumenta las tasas de implantación y gestación y reduce la de aborto.

Los efectos de la estimulación sobre el endometrio podrían perjudicar el resultado de los tratamientos de reproducción en fresco en este tipo de pacientes.

Gracias a la técnica de la vitrificación, la calidad de los embriones no se ve alterada por la postergación de la transferencia.

Según la OMS, en 2016 el 40 % de la población mundial femenina adulta tenía sobrepeso y alrededor de un 15 % padecía obesidad. Los efectos negativos de estas alteraciones endocrinas sobre la fertilidad son conocidos, razón por la cual los especialistas recomiendan siempre buscar el embarazo en un peso normal para poder sobrellevarlo con menos riesgos y así no incidir negativamente en la salud del bebé.

Tal y como investigadores de IVI han presentado hoy en el 74º Congreso de la Sociedad Americana para la Reproducción Asistida (ASRM), las mujeres con obesidad podrían beneficiarse de la transferencia diferida del embrión, algo que, según un estudio prospectivo, elimina la correlación entre las tasas de implantación, aborto y recién nacido vivo y los índices de obesidad y grasa corporal.

“En vez de transferir el embrión solo unos días después de haber estimulado el crecimiento de los óvulos y haberlos extraído, la transferencia se retrasaría a un ciclo posterior, evitando así un posible efecto negativo sobre el endometrio y sin que la calidad de los embriones se vea mermada”, explica Antonio Requena, Director Médico de IVI. Esta postergación es viable gracias a la técnica de la vitrificación –la congelación ultrarrápida en nitrógeno líquido a -196ºC–, en cuyo desarrollo participó IVI y que diariamente se utiliza en las más de 70 clínicas del grupo.

Estos resultados se desprenden del estudio “ABC Trial: Appraisal of body content. Frozen embryo cycles are not impacted by the negative effects of obesity seen in fresh cycles”, liderado por el doctor Kim JG y supervisado por el profesor Richard T. Scott, CEO de IVIRMA Global, en el que se han estudiado los casos de más de 1200 pacientes del grupo de Reproducción Asistida (junio 2016 – abril 2018).

La obesidad, factor de riesgo de infertilidad

Así pues, la transferencia de un embrión vitrificado podría mitigar los efectos negativos de la obesidad observados en ciclos en fresco. Y es que IVI lleva años investigando la correlación existente entre la obesidad y la disminución de la fertilidad de las pacientes. De hecho, es frecuente que las mujeres obesas necesiten un mayor plazo de tiempo para conseguir un embarazo de forma espontánea e incluso tienen tres veces más probabilidades de tener problemas de infertilidad que las mujeres con normopeso.

“Esto se debe a la implicación de diversos factores, como la baja receptividad endometrial, que afectan a su pronóstico reproductivo”, apunta el Dr. Requena. “Las tasas de implantación y embarazo disminuyen significativamente conforme aumenta el IMC femenino. Además, el riesgo de complicaciones obstétricas es tres veces superior en mujeres obesas, aumentan las tasas de aborto y tienen el doble de riesgo de muerte fetal y de parto prematuro que las mujeres con peso normal”, añade el especialista.

Por otro lado, la obesidad no solo afecta a la mujer, sino que en la adolescencia y la edad adulta de los hijos es un factor de riesgo importante para las enfermedades crónicas, como la enfermedad cardiovascular, el síndrome metabólico y la diabetes tipo II.

Así pues, aunque parece que con el uso de la transferencia diferida se podría mejorar el pronóstico reproductivo de estas pacientes, los especialistas de IVI siempre recomiendan que las mujeres afronten la gestación con un peso lo más cercano posible a la normalidad. Para conseguirlo, los ginecólogos aconsejan un plan de reducción de peso y modificar los malos hábitos nutricionales que se puedan tener. Es importante consultar con un especialista en nutrición y realizar ejercicio bajo la supervisión de un preparador físico, ya que está comprobado que el ejercicio moderado tanto en el varón como en la mujer mejora los resultados en tratamientos de Reproducción Asistida.

Sobre IVI – RMANJ

IVI nació en 1990 como la primera institución médica en España especializada íntegramente en reproducción humana. Desde entonces ha ayudado a nacer a más de 160.000 niños, gracias a la aplicación de las últimas tecnologías en Reproducción Asistida. A principios de 2017, IVI se fusionó con RMANJ, convirtiéndose en el mayor grupo de Reproducción Asistida del mundo. Actualmente cuenta con más de 70 clínicas en todo el mundo y es líder en medicina reproductiva. https://ivi.es/http://www.rmanj.com/

 

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