An update of impact of obesity on female infertility and its management

Abstract

With the increase in worldwide incidence of obesity the incidence of obese infertile couples has significantly increased. Obesity has a significant effect on the outcomes of in vitro fertilization with clinical impact on oocytes, endometrium as well as preimplantation embryos. Also it takes longer time for stimulation with higher doses of gonadotropins, greater time for stimulation along with higher cancellation cycles raising the cost factor. Further obesity is associated with higher incidence of PCOS along with its metabolic sequelae. Pregnancy in obesity is further confounded with multiple complications like PIH, higher incidence of preterm labour, still birth incidence along with greater chances of caesarean delivery. Yet there is no certainty whether prior weight reduction therapies help in achieving better incidence of live birth rates with poor efficacy of currently available antiobesity therapies and even the most effective bariatric surgery. More studies are needed to develop better antiobesity drugs and study bariatric surgery with prospective trials for improving the understanding of effectiveness of obesity treatment prior to pregnancy.