This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

/pdf/exercise-as-medicine-evidence-for-prescribing-exercise-as-4ap89k53ch.pdf

Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

인공고관절의 세라믹 볼 헤드의 기계적 안정성 평가를 위한 3 차원 유한요소 해석

Hyperglycemia and Adverse Pregnancy Outcomes

studydesign,size,duration: This guideline was produced by a group of experts in the field using the methodology of the Manual for ESHRE Guideline Development, including a thorough systematic search of the literature, quality assessment of the included papers up to January 2012 and consensus within the guideline group on all recommendations. To ensure input from women with endometriosis, a patient representative was part of the guideline development group. In addition, patient and additional clinical input was collected during the scoping and review phase of the guideline.

/pdf/eshre-guideline-management-of-women-with-endometriosis-27txt9547p.pdf

ESHRE guideline: management of women with endometriosis

Endometriosis

RESULTS: The cumulative live birth rate within three treatment cycles was 41.4% [95% confidence interval (CI) 32.1– 50.7] in obese women with BMI $30 kg/m 2 and 50.3 (95% CI 47.0–53.7) in normal weight women with BMI 18.5– 24.9 kg/m 2 . Obesity was associated with an increased risk of early pregnancy loss occurring before 6 weeks gestation. Positive correlation between BMI and gonadotrophin requirement during stimulation and negative correlation between BMI and number of collected oocytes were observed. Underweight (BMI < 18.5 kg/m 2 ) was not related to an impaired outcome of IVF or ICSI. CONCLUSIONS: Obesity is associated with lower chances for live birth after IVF and ICSI and with an impaired response to ovarian stimulation.

https://www.researchgate.net/profile/Peter_Fedorcsak/publication/233740615_Impact_of_overweight_and_underweight_on_assisted_reproduction_treatmen/links/00b49526ea482593e0000000.pdf?origin=publication_detail

Impact of overweight and underweight on assisted reproduction treatment

Background. Experience with polycystic ovary syndrome shows that insulin resistance is related to early pregnancy loss. This association was examined by comparing pregnancy outcome in obese and lean women. Methods. A cohort of 383 patients conceiving after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was studied. Ovarian stimulation was achieved by GnRHa and FSH or hMG ( n =362), by FSH or hMG alone ( n =16), or by clomiphene citrate and FSH or hMG ( n =5). Luteal phase was supported with progesterone. Pregnancies were defined by >10 IU/l plasma s-hCG on day 14. Ultrasound scan on week 6 and week 12 confirmed fetal viability. Results. Lean group (body mass index [BMI]<25 kg/m 2 ; n =304) and obese group (BMI ≥25 kg/m 2 ; n =79) were established. Obese patients had fewer oocytes collected (median: 8 vs 10 p =0.03), they had higher abortion rate during the first 6 weeks (22% vs 12%; p =0.03) and lower live-birth rate (63% vs 75%; p =0.04). The relative risk of abortion before week...

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1034/j.1600-0412.2000.079001043.x

Obesity is a risk factor for early pregnancy loss after ivf or icsi

Background Intracytoplasmic sperm injection (ICSI) is a method of assisted reproductive technology that involves the selection of a single sperm cell and the manual injection of this cell into the egg. The lack of relevant experimental studies, the nature of the technology involving non-natural selection of the fertilizing sperm, and possible damage to the egg have caused concern that ICSI could increase the risk of birth defects. Data from available cohort studies comparing ICSI with standard in vitro fertilization (IVF) should be combined to evaluate the risks involved with ICSI. Methods We reviewed more than 2500 titles and abstracts containing keywords related to ICSI and identified 22 scientific articles with data on birth defects among ICSI-births. A total of four peer-reviewed, non-overlapping prospective cohort studies provided reliable and comparable data on birth defects both for children conceived by ICSI and children conceived by standard IVF. These studies included a total of 5395 children born after ICSI. Results The pooled estimate of the risk of a major birth defect was a 1.12-fold increase after ICSI when compared with standard IVF (risk ratio = 1.12, 95% confidence interval (CI): 0.97-1.28, P = 0.12). There was no marked heterogeneity of risk ratios between these studies (P = 0.10). We found no significantly increased risks after ICSI for any of the categories cardiovascular defects, musculoskeletal defects, hypospadias, neural tube defects, or oral clefts. Conclusions Our analysis does not indicate that the ICSI-procedure represents significant additional risks of major birth defects in addition to the risk involved in standard IVF. The data was limited, particularly on risks of specific categories of defects.

Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a meta-analysis

Endometriosis is a common condition in women of reproductive age. In addition to pain, endometriosis may also reduce fertility. The causes of infertility in women with endometriosis may range from anatomical distortions due to adhesions and fibrosis to endocrine abnormalities and immunological disturbances. In some cases, the various pathophysiological disturbances seem to interact through mechanisms so far not fully understood. Whether surgery should be offered as a treatment option in endometriosis-associated infertility has become controversial, partly due to its modest or undocumented effect. Medical or hormonal treatment alone has little or no effect and should only be used in conjunction with assisted reproductive technology (ART). Of the various methods of ART, intrauterine insemination, due to its simplicity, can be recommended in women with minimal or mild peritoneal endometriosis, even though insemination may yield a lower success rate than in women without endometriosis. In vitro fertilization (IVF) is an effective treatment option in less-advanced disease stages, and the success rates are similar to the results in other causes of infertility. However, women with more advanced stages of endometriosis have lower success rates with IVF.

https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/aogs.13082

Tom Tanbo

Papers

Impact of overweight and underweight on assisted reproduction treatment

Obesity is a risk factor for early pregnancy loss after ivf or icsi

Birth defects in children conceived by ICSI compared with children conceived by other IVF-methods; a meta-analysis

Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options

Body weight, hyperinsulinemia, and gonadotropin levels in the polycystic ovarian syndrome: evidence of two distinct populations.