The association between obesity and infertility has gained increasing provider and public awareness. The purpose of this review is to outline the recent research into the pathophysiology regarding obesity and its impact of reproductive function in both women and men.
A BMI more than 25 has a detrimental impact on the hypothalamus-pituitary-gonadal (HPG) axis in both men and women, leading to alterations of HPG hormones, gametogenesis, as well as an increase in inflammation and lipotoxicity from excessive adipose tissue. Additionally, BMI likely impacts assisted reproductive technology (ART) outcomes, with a greater influence on women than men. Studies regarding weight loss interventions are heterogenous in methods and outcomes, and it is difficult to extrapolate from current data if weight loss truly leads to improved outcomes.
Elevated BMI induces changes in the HPG axis, hormone levels, gametogenesis, and adverse ART outcomes. Inconsistencies regarding weight loss interventions make it difficult to assess the impact on outcomes after weight loss interventions.
aDepartment of Obstetrics & Gynecology, Wright Patterson Air Force Base, Wright Patterson AFB
bDepartment of Obstetrics & Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, Ohio, USA
cShanghai Jiaotong University School of Medicine, Shanghai, China
Correspondence to Tanya Glenn, MD, Miami Valley Hospital, 128 Apple Street, Suite 3800 Weber CHE, Dayton, OH 45409, USA. Tel: +1 937 208 2301; fax: +1 937 222 7255; e-mail: firstname.lastname@example.org