Mechanisms of fertility disorders in obese women

Abstract

Obesity is a common problem among women of reproductive age. Overweight is known to negatively affect a woman’s fertility. So, women of reproductive age who are obese may experience menstrual irregularities, endometrial pathology and, ultimately, infertility. The pathogenetic mechanisms of reproductive dysfunction in obesity remain actively studied issues. It was established that leptin synthesized by adipose tissue inhibits granulosis, cell steroidogenesis and interferes with the ovulation process, which can directly affect reproductive function. Insulin resistance and compensatory hyperinsulinemia, which accompany obesity in women, can contribute to menstrual irregularities, ovulation and, ultimately, fertility. Obesity is also characterized by a state of «relative functional hyperandrogenism», which can affect ovarian function, contributing to the development of infertility. Moreover, obesity is characterized by a state of hyposomatotropinism, which can affect fertility, through changes in ovarian and endometrial function. Weight loss is most likely able to restore fertility in most cases, but there are no practical guidelines that would help the clinician choose the best method to reduce body weight from increased physical activity, dietary restrictions, drug therapy and bariatric surgery.

Keywords

• obesity
• impaired fertility of a woman
• infertility
• overview