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Obesity and infertility

Pasquali, Renato; Patton, Laura; Gambineri, Alessandra

Current Opinion in Endocrinology, Diabetes and Obesity: December 2007 - Volume 14 - Issue 6 - p 482–487
doi: 10.1097/MED.0b013e3282f1d6cb
Reproductive endocrinology: Edited by Wendy Kuohung

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/m2. 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.

Division of Endocrinology, Department of Internal Medicine, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum of Bologna, Bologna, Italy

Correspondence to Renato Pasquali, MD, Division of Endocrinology, Dept. of Internal Medicine, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Via Massarenti 9, 40138 Bologna, Italy Tel: +39 051 6364147; fax: +39 051 6363080; e-mail: renato.pasquali@unibo.it

© 2007 Lippincott Williams & Wilkins, Inc.