A FIGO Literature Review on the Effects of Obesity on Fertility Challenges

Women with obesity face fertility issues and also have limited access to fertility treatments. A recent paper provides the following guidelines in this regard-

1. BMI as a Factor in Fertility: According to NICE guidelines, obesity has been identified as a potential factor affecting fertility. These guidelines recommend offering weight loss advice to women struggling with fertility issues, recognizing the potential benefits of weight management.
2. Restrictions Based on BMI: The National Infertility Group for Scotland has recommended that women with a BMI over 30 should not be offered fertility treatment. Similar restrictions have been reported by respondents to surveys conducted in Canada and the USA, indicating a widespread practice of imposing BMI cutoffs for fertility treatments.
3. Lifestyle Modification: Despite limited literature on the direct impact of lifestyle modification on fertility, some data suggest that positive effects may be observed when weight loss is achieved and maintained. This underscores the importance of lifestyle factors in addressing fertility concerns.
4. Pharmacological Interventions: Medications such as orlistat and GLP-1 analogs have shown promise in improving fertility outcomes. Orlistat may enhance ovulation rates, while GLP-1 analogs help regulate menstrual cycles, both potentially contributing to increased fertility.
5. Bariatric Surgery: Beyond fertility concerns, bariatric surgery has demonstrated broader health benefits, including improvements in cardiovascular health and reduced mortality risks. Notably, it has also been linked to enhanced ovulation and fertility in women, suggesting a multifaceted approach to addressing both health and fertility issues.

In conclusion, while the direct impact of lifestyle modification on fertility is still an area of ongoing research, emerging evidence suggests its potential benefits. Additionally, pharmacological interventions and bariatric surgery offer promising avenues for improving fertility outcomes, emphasizing the importance of a holistic approach to reproductive health.

Gautam D, Purandare N, Maxwell CV, Rosser ML, Mocanu E, McKeown C, Malhotra J, McAuliffe FM. The challenges of obesity for fertility: A FIGO literature review. International Journal of Gynecology & Obstetrics.2023;160:50-55. https://doi.org/10.1002/ijgo.14538