Hostname: page-component-84b7d79bbc-fnpn6 Total loading time: 0 Render date: 2024-07-25T20:17:15.917Z Has data issue: false hasContentIssue false

Infertility and overweight

Published online by Cambridge University Press:  11 September 2013

Get access

In a nutshell

Excess fatness adversely affects fertility, decreasing pregnancy rates by approximately 30%, both for natural and assisted reproduction. It does so by changing the hormonal, inflammatory and energetic environment in both men and women.

There is some evidence that weight reduction (including through bariatric surgery in the obese) can help reverse this. However, we lack RCTs to confirm this.

Type
Brief Report
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References:

1. Cabler, S. et al. Obesity: modern man's fertility nemesis. Asian J Androl. 2010 Jul;12(4):480–9.CrossRefGoogle ScholarPubMed
2. Hammoud, AO. et al. Obesity and male reproductive potential. J Androl. 2006 Sep-Oct;27(5):619–26.CrossRefGoogle ScholarPubMed
3. Brewer, CJ. et al. The adverse effects of obesity on conception and implantation. Reproduction. 2010 Sep;140(3):347–64.CrossRefGoogle ScholarPubMed
4. Pasquali, R. et al. Obesity and reproductive disorders in women. Hum Reprod Update. 2003 Jul-Aug;9(4):359–72.CrossRefGoogle ScholarPubMed
5. Brody, S. Slimness is associated with greater intercourse and lesser masturbation frequency. J Sex Marital Ther. 2004 Jul-Sep;30(4):251–61.CrossRefGoogle ScholarPubMed
6. Mah, PM. et al. Obesity and testicular function. Mol Cell Endocrinol. 2010 Mar 25;316(2):180–6.CrossRefGoogle ScholarPubMed
7. Hammoud, AO. et al. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril. 2008 Oct;90(4):897904.CrossRefGoogle ScholarPubMed
8. Jokela, M. et al. Lower fertility associated with obesity and underweight: the US National Longitudinal Survey of Youth. Am J Clin Nutr. 2008 Oct;88(4):886–93.CrossRefGoogle ScholarPubMed
9. Ramlau-Hansen, CH. et al. Subfecundity in overweight and obese couples. Hum Reprod. 2007 Jun;22(6):1634–7.CrossRefGoogle ScholarPubMed
10. Nguyen, RH. et al. Men's body mass index and infertility. Hum Reprod. 2007 Sep;22(9):2488–93.CrossRefGoogle ScholarPubMed
11. Wegner, CC. et al. Abnormally high body mass index and tobacco use are associated with poor sperm quality as revealed by reduced sperm binding to hyaluronan-coated slides. Fertil Steril. 2010 Jan;93(1):332–4.CrossRefGoogle ScholarPubMed
12. Hofny, ER. et al. Semen parameters and hormonal profile in obese fertile and infertile males. Fertil Steril. 2010 Jul;94(2):581–4.CrossRefGoogle ScholarPubMed
13. Chavarro, JE. et al. Body mass index in relation to semen quality, sperm DNA integrity, and serum reproductive hormone levels among men attending an infertility clinic. Fertil Steril. 2010 May 1;93(7):2222–31.CrossRefGoogle ScholarPubMed
14. Aggerholm, AS. et al. Is overweight a risk factor for reduced semen quality and altered serum sex hormone profile? Fertil Steril. 2008 Sep;90(3):619–26.CrossRefGoogle ScholarPubMed
15. Fejes, I. et al. Effect of body weight on testosterone/estradiol ratio in oligozoospermic patients. Arch Androl. 2006 Mar-Apr;52(2):97102.CrossRefGoogle ScholarPubMed
16. MacDonald, AA. et al. The impact of body mass index on semen parameters and reproductive hormones in human males: a systematic review with meta-analysis. Hum Reprod Update. 2010 May-Jun;16(3):293311.CrossRefGoogle ScholarPubMed
17. Yilmaz, N. et al. The relationship between obesity and fecundity. J Womens Health (Larchmt). 2009 May;18(5):633–6.CrossRefGoogle ScholarPubMed
18. Zaadstra, BM. et al. Fat and female fecundity: prospective study of effect of body fat distribution on conception rates. BMJ. 1993 Feb 20;306(6876):484–7.CrossRefGoogle ScholarPubMed
19. Gesink, Law DC. et al. Obesity and time to pregnancy. Hum Reprod. 2007 Feb;22(2):414–20.CrossRefGoogle Scholar
20. Lake, JK. et al. Women's reproductive health: the role of body mass index in early and adult life. Int J Obes Relat Metab Disord. 1997 Jun;21(6):432–8.CrossRefGoogle Scholar
21. Rich-Edwards, JW. et al. Adolescent body mass index and infertility caused by ovulatory disorder. Am J Obstet Gynecol. 1994 Jul;171(1):171–7.CrossRefGoogle ScholarPubMed
22. Kuchenbecker, WK. et al. The subcutaneous abdominal fat and not the intraabdominal fat compartment is associated with anovulation in women with obesity and infertility. J Clin Endocrinol Metab. 2010 May;95(5):2107–12.CrossRefGoogle Scholar
23. Orvieto, R. et al. The influence of body mass index on in vitro fertilization outcome. Int J Gynaecol Obstet. 2009 Jan;104(1):53–5.CrossRefGoogle ScholarPubMed
24. Lenoble, C. et al. [Effect of women's weight on the success rate of in vitro fertilization] Gynecol Obstet Fertil. 2008 Sep;36(9):940–4.CrossRefGoogle ScholarPubMed
25. Matalliotakis, I. et al. Impact of body mass index on IVF and ICSI outcome: a retrospective study. Reprod Biomed Online. 2008 Jun;16(6):778–83.CrossRefGoogle ScholarPubMed
26. Maheshwari, A. et al. Effect of overweight and obesity on assisted reproductive technology--a systematic review. Hum Reprod Update. 2007 Sep-Oct;13(5):433–44.CrossRefGoogle ScholarPubMed
27. Metwally, M. et al. Does high body mass index increase the risk of miscarriage after spontaneous and assisted conception? A meta-analysis of the evidence. Fertil Steril. 2008 Sep;90(3):714–26.CrossRefGoogle Scholar
28. Sneed, ML. et al. Body mass index: impact on IVF success appears age-related. Hum Reprod. 2008 Aug;23(8):1835–9.CrossRefGoogle ScholarPubMed
29. Vahratian, A. et al. Should access to fertility-related services be conditional on body mass index? Hum Reprod. 2009 Jul;24(7):1532–7.CrossRefGoogle ScholarPubMed
30. Metwally, M. et al. Reproductive endocrinology and clinical aspects of obesity in women. Ann N Y Acad Sci. 2008 Apr;1127:140–6.Google Scholar
31. Kershaw, EE. et al. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab. 2004 Jun;89(6):2548–56.CrossRefGoogle ScholarPubMed
32. Bohler, H Jr. et al. Adipose tissue and reproduction in women. Fertil Steril. 2010 Aug;94(3):795825.CrossRefGoogle ScholarPubMed
33. Vital, Reyes VS. et al. [TNF-alpha, C-reactive protein and serum adiponectin modified in infertile patients with insulin resistance] Ginecol Obstet Mex. 2008 Nov;76(11):659–66.Google Scholar
34. Schneider, JE. et al. Leptin and metabolic control of reproduction. Horm Behav. 2000 Jun;37(4):306–26.CrossRefGoogle ScholarPubMed
35. Tena-Sempere, M. Roles of ghrelin and leptin in the control of reproductive function. Neuroendocrinology. 2007;86(3):229–41.CrossRefGoogle ScholarPubMed
36. Mircea, CN. et al. Metabolic fuel and clinical implications for female reproduction. J Obstet Gynaecol Can. 2007 Nov;29(11):887902.CrossRefGoogle ScholarPubMed
37. Gao, Q. et al. Cross-talk between estrogen and leptin signaling in the hypothalamus. Am J Physiol Endocrinol Metab. 2008 May;294(5):E81726.CrossRefGoogle ScholarPubMed
38. Gosman, GG. et al. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update. 2006 Sep-Oct;12(5):585601.CrossRefGoogle ScholarPubMed
39. Quennell, JH. et al. Leptin indirectly regulates gonadotropin-releasing hormone neuronal function. Endocrinology. 2009 Jun;150(6):2805–12.CrossRefGoogle ScholarPubMed
40. Cervero, A. et al. Leptin system in embryo development and implantation: a protein in search of a function. Reprod Biomed Online. 2005 Feb;10(2):217–23.CrossRefGoogle ScholarPubMed
41. Brannian, JD. et al. Leptin and ovarian folliculogenesis: implications for ovulation induction and ART outcomes. Semin Reprod Med. 2002 May;20(2):103–12.CrossRefGoogle ScholarPubMed
42. Lindheim, SR. et al. Circulating leptin levels during ovulation induction: relation to adiposity and ovarian morphology. Fertil Steril. 2000 Mar;73(3):493–8.CrossRefGoogle ScholarPubMed
43. Alfer, J. et al. The endometrium as a novel target for leptin: differences in fertility and subfertility. Mol Hum Reprod. 2000 Jul;6(7):595601.CrossRefGoogle ScholarPubMed
44. Chen, B. et al. Leptin and varicocele-related spermatogenesis dysfunction: animal experiment and clinical study. Int J Androl. 2009 Oct;32(5):532–41.CrossRefGoogle ScholarPubMed
45. Hanafy, S. et al. Serum leptin correlates in infertile oligozoospermic males. Andrologia. 2007 Oct;39(5):177–80.CrossRefGoogle ScholarPubMed
46. Shafi, R. et al. Status of serum leptin levels in females with infertility. Saudi Med J. 2008 Oct;29(10):1419–22.Google ScholarPubMed
47. Ishikawa, T. et al. Ghrelin expression in human testis and serum testosterone level. J Androl. 2007 Mar-Apr;28(2):320–4.CrossRefGoogle ScholarPubMed
48. Steinman, N. et al. Serum leptin concentrations are higher in azoospermic than in normozoospermic men. Fertil Steril. 2001 Apr;75(4):821–2.CrossRefGoogle ScholarPubMed
49. Chan, JL. et al. Role of leptin in energy-deprivation states: normal human physiology and clinical implications for hypothalamic amenorrhoea and anorexia nervosa. Lancet. 2005 Jul 2-8;366(9479):7485.CrossRefGoogle ScholarPubMed
50. Salvador, J. et al. Perspectives in the therapeutic use of leptin. Expert Opin Pharmacother. 2001 Oct;2(10):1615–22.CrossRefGoogle ScholarPubMed
51. Oshakbaev, KP. et al. [Overweight and secretory male infertility] Urologiia. 2009 Nov-Dec;(6):43–7.Google Scholar
52. Clark, AM. et al. Weight loss results in significant improvement in pregnancy and ovulation rates in anovulatory obese women. Hum Reprod. 1995 Oct;10(10):2705–12.CrossRefGoogle ScholarPubMed
53. Hollmann, M. et al. Effects of weight loss on the hormonal profile in obese, infertile women. Hum Reprod. 1996 Sep;11(9):1884–91.CrossRefGoogle ScholarPubMed
54. Mutsaerts, MA. et al. The LIFESTYLE study: costs and effects of a structured lifestyle program in overweight and obese subfertile women to reduce the need for fertility treatment and improve reproductive outcome. A randomised controlled trial. BMC Womens Health. 2010 Jun 25;10:22.CrossRefGoogle ScholarPubMed
55. Van Der Spuy, ZM. et al. Weight reduction, fertility and contraception. IPPF Med Bull. 1983 Oct;17(5):24.Google ScholarPubMed
56. Scott, EC. et al. Critical fat, menarche, and the maintenance of menstrual cycles: a critical review. J Adolesc Health Care. 1982 Jun;2(4):249–60.CrossRefGoogle ScholarPubMed
57. Maggard, MA. et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008 Nov 19;300(19):2286–96.CrossRefGoogle ScholarPubMed
58. Guelinckx, I. et al. Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update. 2009 Mar-Apr;15(2):189201.CrossRefGoogle ScholarPubMed