Obesity and its impact on reproductive medicine

Rechkemmer A. · Revista Peruana de Ginecologia y Obstetricia (2025) · DOI: 10.31403/rpgo.v71i2745

Resumen

Obesity has a negative impact on reproductive health, with a higher incidence of anovulation, menstrual disorders and infertility. The increase in adipose tissue is associated with insulin resistance and hyperinsulinemia, reduction in sex hormone binding globulin levels, and hyperandrogenemia. There is an increase in pro-inflammatory adipokines and a decrease in adiponectins. Female obesity is associated with ovulatory dysfunction, lower ovarian response to ovulation inducers, decreased oocyte quantity and quality, and alteration in endometrial receptivity. Likewise, a decrease in the live birth rate has been reported in in vitro fertilization treatments, and an increase in the frequency of abortions. Male obesity increases the incidence of erectile dysfunction and alterations in sperm quality. Diet, exercise, and medical therapy have been shown to be effective. Bariatric surgery is an alternative in cases of body mass index greater than 40, and achieves a rapid and effective weight reduction, with improvement in metabolic parameters; it is recommended to postpone pregnancy in women for at least one year after surgery. Bariatric surgery significantly reduces the risk of fetal macrosomia, pregnancy-associated hypertension, and gestational diabetes. However, it increases the risk of maternal anemia and small-for-gestational-age newborns.

Instituciones: Universidad Peruana Cayetano Heredia