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The Role of Obesity in Reproduction

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Biennial Review of Infertility

Abstract

Obesity has risen to epidemic proportions worldwide and affects more than two thirds of US adults. In both genders, obesity is associated with impaired fertility, primarily due to disorders of the reproductive hormonal profile. Across the reproductive spectrum, obesity is associated with greater risks for adverse health outcomes, including higher rates of infertility, subfertility, early pregnancy loss, fetal deaths and stillbirths, congenital anomalies, and pregnancy complications. The excess reproductive morbidity associated with obesity may increase with longer duration, making the current trends among children and young adults particularly critical in terms of their future reproductive potential. Clinical and epidemiologic studies strongly implicate prenatal growth restriction followed by early childhood catch-up growth with development of symptoms of polycystic ovary syndrome by early adolescence. Abnormal glycemic parameters, including high dietary glycemic load, fasting, and 2-h glucose levels, and fasting insulin have also been linked to adverse reproductive outcomes, further increased in the presence of obesity. A recent national study of ART reported reduced clinical pregnancy rate with increasing BMI with autologous but not donor oocytes and reduced live birth rate with increasing BMI regardless of oocyte source. These findings point to the need for dietary periconceptional and prenatal therapies targeted at improving the metabolic environment in obese women. Weight loss should be the first-line treatment for overweight men and women considering pregnancy. In addition to dietary modifications to facilitate weight loss, lifestyle factors such as regular physical exercise, elimination of tobacco use and alcohol consumption, behavior modification, and stress management may be of benefit.

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, MI, USA

    Barbara Luke

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  1. Barbara Luke
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Correspondence to Barbara Luke .

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Editors and Affiliations

  1. Brigham & Women's Hospital, Dept. Obstetrics & Gynecology, Harvard Medical School, Francis St. 75, Boston, 02115, Massachusetts, USA

    Catherine Racowsky

  2. Weill Cornell Medical Center, Dept. Urology, New York Presbyterian Hospital, East 68th St. 525, New York, 10021, New York, USA

    Peter N. Schlegel

  3. , Department of Reproductive Medicine, University Medical Center Utrecht, PO Box 85500, Utrecht, 3508 GA, Netherlands

    Bart C. Fauser

  4. Departments of Surgery (Urology), Obstetrics & Gynecology & Physiology, Andrology and IVF Laboratories, Arapeen Dr. 675, Salt Lake City, 84108, Utah, USA

    Douglas T. Carrell

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Luke, B. (2011). The Role of Obesity in Reproduction. In: Racowsky, C., Schlegel, P., Fauser, B., Carrell, D. (eds) Biennial Review of Infertility. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-8456-2_4

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