Prevalence of obesity

The prevalence of obesity is increasing & has become epidemic worldwide. Obesity has detrimental effects on all the systems human body, including reproductive health. Overweight women have a higher incidence of menstrual dysfunction and anovulation. Thus obese women have poor reproductive outcomes. i.e. may require assisted reproduction such as ovulation induction  I.V.F., ovum donation.

Effect of obesity on H.P.O. axis:-

1. Obese women have increased leptin (a protein produced in adipose tissue and termed adipokine )which leads to the downregulation of its receptor in the brain.
2. Amplitude L.H. plasticity is decreased in obese women.

Effect of obesity on natural fertility:-

1. Menstrual abnormalities.
2. Ovulation dysfunction- due to increased insulin production in obese women there is decreased production of gonadotropin.
3. Inhibits ovarian function.
4. There is a decrease in L.H. plasticity amplitude, so there is a decrease in spontaneous conception by diminished internal progesterone level

Effects of obesity on assisted reproduction:-

1. Reduced ovarian responsiveness to ovulation-inducing agents.
2. Altered oocyte as well as endometrial function and abnormal embryogenesis.

Effects of obesity on the male reproductive system.

• Obese men have an increased incidence of oligozoospermia and asthenozoospermia.
• Obesity is associated with erectile dysfunction in men.

Management-

• The goal of the therapy is to improve obesity-related comorbid conditions and reduce the risk of future development of pregnancy-related complications.
• Lifestyle modification is the first line of treatment for obesity.

• Thus, by lifestyle modification and other therapies obesity needs to be treated, as it impairs the reproductive function in both man & woman.