title: Obesity and reproductive function: a review of the evidence.
abstract: OBJECTIVE
  Over the last decade, the evidence linking obesity to impaired reproductive function has grown. In this article, we review this evidence and discuss the underlying pathophysiology.
  
  
  RESULTS
  Obese women are less likely than normal-weight women to achieve pregnancy. Female obesity adversely affects reproductive function through alterations in the hypothalamic-pituitary-ovarian axis, oocyte quality, and endometrial receptivity. It is unclear which mechanism contributes the most to subfecundity, and it is likely a cumulative process. Emerging data highlight the contribution of male obesity to impaired reproductive function and that couple obesity has synergistic adverse effects. Once pregnant, obese women are at higher risk for adverse pregnancy outcomes. Weight loss improves reproductive potential in obese patients. As obese women surpass 35 years of age, age may be more important than body mass index in determining reproductive potential.
  
  
  CONCLUSIONS
  Obstetrician gynecologists need to be aware of the negative impact of obesity on reproductive function so that they appropriately counsel their patients. Further work is needed to clarify the underlying pathophysiology responsible for adverse effects of obesity on reproduction so that novel treatment approaches may be developed.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University School of Medicine, Washington University, St. Louis, Missouri, USA.
authors.forename: Violet E
authors.initials: VE
authors.lastname: Klenov
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jungheim
mesh_terms: D003131:Combined Modality Therapy; D015536:Down-Regulation; D004717:Endometrium / Q000503:physiopathology; D019317:Evidence-Based Medicine; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007247:Infertility, Female / Q000209:etiology* / Q000517:prevention & control; D007248:Infertility, Male / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D009765:Obesity / Q000503:physiopathology* / Q000628:therapy; D009866:Oogenesis; D010053:Ovary / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D013091:Spermatogenesis; D013737:Testis / Q000503:physiopathology; D015431:Weight Loss