Effect Of Obesity On Assisted Reproductive Treatment Outcomes And Its Management: A Literature Review

Key contentObesity is associated with infertility and poor obstetric outcomes.The current trends of advanced maternal age and rising obesity rates contribute indirectly to the growing demand for fertility treatment and assisted reproduction treatment (ART), posing clinical and ethical dilemmas for fertility service providers.The live-birth rate, after ART, is significantly lower in obese women than non-obese women, possibly due to impaired oocyte quality and/or defective endometrial receptivity. Poor ART outcomes correlate positively with the severity of obesity.Management of obesity-related infertility should include diet, exercise, cognitive behavioural interventions and possibly adjunctive pharmacotherapy. Bariatric surgery may benefit morbidly obese women who struggle to lose weight otherwise.Randomised controlled trials are required to clarify the effects of various therapeutic interventions for obesity on ART outcomes.Learning objectivesTo understand the association of obesity and infertility with ART outcomes.To learn the principles of obesity-related infertility management.Ethical issuesTo understand the ethical challenges in the provision of ART for obese women and to inform the stance of professional bodies, such as the British Fertility Society and the European Society of Human Reproduction and Embryology.