Associations Between Visceral Adipose Tissue Area and Infertility: a Cross-Sectional Analysis

Research Question: The effect of obesity on fertility has been studied in recent years. However, the direct relationship between intra-abdominal fat obesity and female reproductive health remains inconclusive.Design: The study analysis data from the 2013-2018 National Health and Nutrition Examination Survey, with a total of 3013 women were enrolled. The participants were divided into an “infertility” group and a “non-infertility” group. Differences between two groups were analyzed using a weighted Student's t-test or Mann-Whitney U test for continuous variables or a weighted Chi-squared test for categorical data. Visceral adipose tissue area (VATA) is assessed by dual-energy X-ray absorptiometry. The independent association between infertility and log VATA was assessed by weighted multivariate logistic regression models. Subgroup analyses were performed to assess the strength of the results. Interaction tests were used to examine whether covariates interacted with log VATA to influence infertility.Results: The results showed that log VATA was significantly higher in the infertility group than in the non-infertility group. After adjustment for potential confounders, the results of multivariate logistic regression analysis revealed that an increase in log VATA was associated with a growing prevalence of female infertility (OR=2.453, 95% CI: 1.278-4.792). Subgroup analyses showed this association was still consistent in individuals under 35 years old (P=0.002), Mexican-American (P=0.033), non-hypertensive (P=0.013), and non-diabetic individuals (P=0.003).Conclusions: This study showed that enlarged VATA was associated with an increased risk of infertility. The direct effect of VATA on female infertility needs to be further clarified to provide a basis for future prevention and treatment of female infertility.