The effects of obesity on female reproductive functionΧριστίνα Ιωακειμίδου
MD, MSc, MRCOG, BSCCP Obstetrician & Gyneacologist
Member of the Royal College of Obstetricians & Gyneacologists
The continuously increasing prevalence of overweight and obesity constitutes an epidemic of modern society. It has substantial effects on every system and function of the human body and reproduction is not an exemption.
Reproduction is particularly affected in the domain of fertility, fertility treatment, pregnancy and neonatal outcome. Overweight and obese women suffer more frequently from menstrual dysfunction and anovulation, leading to subfecundity and infertility. Poor outcome is evident in both natural and assisted conception, with decreased conception rates, increased miscarriage rates and pregnancy complications. The underlying pathophysiological mechanism is not lucid and there have been several factors studied. The hypothalamic-pituitary-ovarian (HPO) axis is affected via different peptides and hormones and the resulting hormonal imbalance impacts on the oocyte quality as well as endometrial receptivity.
Cessation of follicular growth, derangement of oocyte maturation process as well as impaired endometrial development and implantation are the main parameters involved.
Polycystic ovarian syndrome (PCOS) in obese patients presents with a more severe phenotype, exacerbating their fertility problems.
The response of overweight and obese women to fertility treatment may be different compared with normal weight patients. Most researchers agree that the rate of miscarriages is elevated and the same stands for pregnancy complications and neonatal outcomes.
Lifestyle changes and gradual weight reduction has beneficial effects but age is the main determinant of conception, so a balance should be kept in mind when advice is given to postpone fertility treatment in order to follow a weight loss plan. This literature review will try to present the available evidence around the effects of obesity upon reproductive functions and its relation with fertility treatments.