Impact of obesity on female fertility and fertility treatment

Abstract

The prevalence of obesity in women of reproductive age, and in the infertile population, continues to increase with recent recognition that abdominal obesity is associated with greater metabolic disturbances and reduced conception, even in ovulating women. Obesity contributes to anovulation and menstrual irregularities, reduced conception rates and a reduced response to fertility treatment. It also increases miscarriage, congenital anomalies and contributes to maternal and peri-natal complications. Obese women undergoing fertility treatment should therefore be advised of the increased risks they are undertaking. Obesity independent of polycystic ovary syndrome (PCOS) is associated with anovulation, and minimal weight loss alone is an effective therapy for induction of ovulation in both obese women and obese PCOS women. Studies also show the effects of reduced fertility in overweight men. Consequently, lifestyle programmes encouraging weight loss, along with medical or surgical treatment of obesity, should be considered to be an ovulation induction treatment and due consideration for a potential pregnancy in an obese woman given, prior to other fertility treatments.