Abstract

Purpose of review: To summarize major factors affecting fertility in obesity.

Recent findings: Fertility can be negatively affected by obesity. In women, early onset of obesity favours the development of menses irregularities, chronic oligo-anovulation and infertility in the adult age. Obesity in women can also increase risk of miscarriages and impair the outcomes of assisted reproductive technologies and pregnancy, when the body mass index exceeds 30 kg/m. The main factors implicated in the association may be insulin excess and insulin resistance. These adverse effects of obesity are specifically evident in polycystic ovary syndrome. In men, obesity is associated with low testosterone levels. In massively obese individuals, reduced spermatogenesis associated with severe hypotestosteronemia may favour infertility. Moreover, the frequency of erectile dysfunction increases with increasing body mass index.

Summary: Much more attention should be paid to the impact of obesity on fertility in both women and men. This appears to be particularly important for women before assisted reproductive technologies are used. Treatment of obesity may improve androgen imbalance and erectile dysfunction, the major causes of infertility in obese men.

Similar articles

• The adverse effects of obesity on conception and implantation.

  Brewer CJ, Balen AH.Reproduction. 2010 Sep;140(3):347-64. doi: 10.1530/REP-09-0568. Epub 2010 Apr 15.PMID: 20395425 Review.

• Obesity, fat distribution and infertility.

  Pasquali R.Maturitas. 2006 Jul 20;54(4):363-71. doi: 10.1016/j.maturitas.2006.04.018. Epub 2006 May 24.PMID: 16725287 Review.

• The effect of obesity on the outcome of infertility management in women with polycystic ovary syndrome.

  Al-Azemi M, Omu FE, Omu AE.Arch Gynecol Obstet. 2004 Dec;270(4):205-10. doi: 10.1007/s00404-003-0537-2. Epub 2003 Aug 29.PMID: 12955532

• The preconceptual contraception paradigm: obesity and infertility.

  Nelson SM, Fleming RF.Hum Reprod. 2007 Apr;22(4):912-5. doi: 10.1093/humrep/del473. Epub 2006 Dec 15.PMID: 17172282

• The impact of body mass index on assisted reproduction.

  Tamer Erel C, Senturk LM.Curr Opin Obstet Gynecol. 2009 Jun;21(3):228-35. doi: 10.1097/GCO.0b013e32832aee96.PMID: 19395966