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Body Fat Distribution and Female Infertility: a Cross-Sectional Analysis Among US Women

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Abstract

At present, the effect of body fat distribution on female reproductive health is still inconclusive. The purpose of our study was to analyze the correlation between female infertility rates and the fat mass portion of the android region to the gynoid region (the A/G ratio) among US women of reproductive age. Female infertility is defined as a failure to get pregnant after 12 months of unprotected sexual activity. A total of 3434 women of reproductive age were included in this study as part of the 2013–2018 National Health and Nutrition Examination Survey (NHANES). The A/G ratio was used to assess the body fat distribution of participants. Based on the comprehensive study design and sample weights, it was determined that the A/G ratio was associated with female infertility primarily through logistic regression analyses. After adjusting for potential confounders, the multivariate regression analysis indicated an increase in the A/G ratio was correlated with an increase in the prevalence of female infertility (OR = 4.374, 95% CI:1.809–10.575). Subgroup analyses showed an increased prevalence of infertility in non-Hispanic Whites (P = 0.012), non-diabetic individuals (P = 0.008), individuals under 35 years old (P = 0.002), and individuals with secondary infertility (P = 0.01). The trend tests and smooth curve fitting illustrate a linear trend between the A/G ratio and female infertility. Future researches are warranted to confirm the causal relationship between body fat distribution and female infertility, which may provide an insight into future prevention and treatment of female infertility.

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Data Availability

The survey data are publicly available on the internet for data users and researchers throughout the world http://www.cdc.gov/nchs/nhanes/.

Code Availability

All statistical analyses were conducted using SAS; programs are available from the corresponding author upon request.

Abbreviations

A/G ratio:

The fat mass portion of the android region to the gynoid region

NHANES:

National Health and Nutrition Examination Survey

CDC:

Centers for Disease Control

PCOS:

Polycystic ovary syndrome

DXA:

Dual-energy X-ray absorptiometry

NCHS:

National Center for Health Statistics

PIR:

Poverty to income ratio

GAM:

The generalized additive model

MRI:

Magnetic resonance imaging

CT:

Computed tomography

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Acknowledgements

We thank the staff and the participants of the NHANES study for their valuable contributions.

Funding

This work was supported by the National Natural Science Foundation of China Youth Fund (No.82104903).

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Authors and Affiliations

  1. Department of Gynecology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, No.155, Hanzhong Road, Qinhuai District, Nanjing, 210000, Jiangsu Province, People’s Republic of China

    Xinzhe Wang, Rui Zhu & Jing Jin

  2. Department of Orthopedics, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China

    Huawei Han

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  1. Xinzhe Wang
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Contributions

R Zhu collected data. HW Han organized the study and performed the statistical analysis. XZ Wang and J Jin drafted the manuscript, to which all authors contributed, and approved the final version for publication.

Corresponding author

Correspondence to Jing Jin.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. All analyses were based on data of the National Health and Nutrition Examination Survey (NHANES). The study was approved by the ethics review board of the National Center for Health Statistics. The detailed information is located on the NHANES website. Written informed consent was obtained from each participant before their inclusion on the NHANES database. Detailed information on the ethics application and written informed consent are provided on the NHANES website.

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The America National Center for Health Statistics has obtained informed consent from each participant before their inclusion. Detailed information is provided on the NHANES website.

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Wang, X., Zhu, R., Han, H. et al. Body Fat Distribution and Female Infertility: a Cross-Sectional Analysis Among US Women. Reprod. Sci. 30, 3243–3252 (2023). https://doi.org/10.1007/s43032-023-01280-2

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