Impact of Obesity on Female Fertility
Obesity is a medical condition that occurs when a person carries excess weight or body fat. Doctors will suggest that a person has obesity if they have a high body mass index (BMI) see Table 1. Obesity negatively impacts the health of women in many ways. Being overweight or obese increases the relative risk of diabetes and coronary artery diseases in females. Women who are obese have a higher risk of low back pain and knee osteoarthritis. Moreover, obesity negatively affects fertility as demonstrated by several experiments. Infertility is a condition that affects approximately 1 out of every 6 couples. Infertility diagnosis is given to couples that have been unsuccessful in efforts to conceive over the course of one full year. When the cause of infertility exists within the female partner, it is referred to as female infertility. Obesity is associated with an increase in circulating insulin levels, which results in increasing functional androgen levels (caused by suppression of sex hormone–binding globulin synthesis and increased ovarian androgen production). Chronic elevation of circulating estrogen is caused by aromatization in peripheral adipose tissue. Additionally, leptin inhibits ovarian follicular development and steroidogenesis and thus may contribute to reproduction difficulties in obese women.
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Obesity and overweight are common conditions that have consequences not only on general health but also to a great extent on reproductive health. There is a high prevalence of obese women in the infertile population and numerous studies have highlighted the link between obesity and infertility. Obesity contributes to anovulation and menstrual irregularities, reduced conception rate and a reduced response to fertility treatment. It also increases miscarriage and contributes to maternal and perinatal complication. Reduction of obesity, particularly abdominal obesity, is associated with improvements in reproductive functions.
