The main purpose of the doctoral dissertation was to determine the influence of exercise and exercise counselling on the expression of genes in the endometrium during the implantation window in infertile women with obesity. We found differences in movement abilities, physical characteristics, psychological well-being, and health and metabolic factors before and after the exercise intervention. At the same time, we also analysed the long-term effects of exercise and exercise counselling with the help of questionnaires. 43 women with confirmed primary or secondary infertility were included in the study. There were 28 subjects in the experimental group, aged 32.4 ± 4.0 years, with an average BMI of 37.66 kg/m2. The training intervention took place for 12 weeks at the Faculty of Sports, where measurements of movement abilities and physical characteristics were performed, and an analysis of health and metabolic factors was performed at the Clinical Department of Reproduction of the University of Ljubljana. The control group consisted of 15 women aged 33.2 ± 3.4 years, with an average BMI of 32.82 kg/m2, who did not receive exercise or exercise counselling.
The data were statistically analysed in the IBM SPSS 21 program (SPSS Inc., Chicago, USA). The research showed that there were no statistically significant differences in the expression of genes that were more highly expressed in the receptive endometrium in previous studies according to the exercise intervention. At the same time, we found that genes that were lower expressed in the receptive endometrium were statistically significantly downregulated in the endometrial samples after successful weight loss. Through research, we found that 12 weeks of continuous exercise had an effect on the improvement of women's movement abilities, physical characteristics and psychological state, as they improved the results of all 9 movement tests, reduced their body weight by 5.79 kg on average and improved their perception 92.9% emotions and feelings. The effects of exercise and exercise counseling were also visible after the end of the intervention; after one year, the women's psychological well-being worsened on average, but they mostly maintained their dietary and exercise habits and body weight, and in the period up to two years after the end of the intervention, as many as 16 of the subjects became pregnant. According to the reviewed literature, our study is the first study on the effect of weight loss on the expression of genes in infertile women with obesity, which are supposed to serve as markers of endometrial receptivity. The results of the research suggest that appropriate exercise and nutrition and the resulting weight loss in infertile women with obesity can have a positive effect on the receptivity of the endometrium, so one of the important approaches in the treatment of these women is the promotion of a healthy lifestyle.
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