The Relationship Between Obesity and Female Reproductive Dysfunction
Obesity is associated with a magnitude of complications. These include metabolic complications, cardiovascular events, tumors, gastrointestinal disorders, arthritis, and infertility. which occurs as a result of complex relationships between genetic, socioeconomic, and cultural influences. Obesity is responsible for an increased risk of impairment of producing offspring and infertility. Obese females are unsatisfactory to meet a need for reproductive outcomes regardless of the mode of conception, so higher body mass index (BMI) is associated with poorer fertility prognosis. Polycystic ovary syndrome (PCOS) is one of the leading causes of infertility, and many women with PCOS are also overweight or obese. Obesity is associated with infertility in women through multiple and complex mechanisms. Briefly, the adipose tissue through the production of many factors, such as leptin, free fatty acids (FFA), and cytokines may affect both ovarian and endometrium functions, with a final alteration in oocyte maturation endometrial receptivity. In addition, through the development of peripheral insulin resistance obesity produces a condition of functional hyperandrogenism and hyperestrogenism that contribute to produce anovulation and reducing endometrial receptivity. Obesity in women represents a significant problem during pregnancy, and childbirth, with a well-recognized reduction in the chance of conception for both Assisted Reproduction Techniques( ART) and non-ART pregnancies as well as an increased risk of complications during pregnancy and childbirth. Although there are no practical indications to guide the clinician to choose the best method among increased physical activity, diet, drugs, and bariatric surgery. Weight reduction represents the most significant factor affecting fertility and pregnancy outcomes. So the best strategy starts with comprehensive lifestyle management and may include the use of approved weight loss medications to ameliorate comorbidities and achieve meaningful clinical outcomes