Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

Female infertility: which role for obesity?

International Journal of Obesity Supplements volume 9, pages 65–72 (2019)Cite this article

Abstract

Obesity is associated with infertility in women through multiple and complex mechanisms. Briefly, the adipose tissue through the production of many factors, such as leptin, free fatty acids (FFA), and cytokines may affect both ovarian and endometrium functions, with a final alteration in oocyte maturation and endometrial epithelium receptivity. In addition, through the development of peripheral insulin resistance obesity produces a condition of functional hyperandrogenism and hyperestrogenism that contribute to produce anovulation and to reduce endometrial receptivity and, therefore participate to cause infertility. Weight loss is able to restore fertility in most cases, but there are no practical indications to guide the clinician to choice the best method among increased physical activity, diet, drugs, and bariatric surgery.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

Similar content being viewed by others

References

  1. Pasquali R, Pelusi C, Genghini S, Cacciari M, Gambineri A. Obesity and reproductive disorders in women. Hum Reprod Update. 2003;9:359–72.

    PubMed  Google Scholar 

  2. Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and reproductive axis: a narrative review. Metabolism. 2013;62:457–78.

    CAS  PubMed  Google Scholar 

  3. Evans JJ, Anderson GM. Balancing ovulation and anovulation: integration of the reproductive and energy balance axes by neuropeptides. Hum Reprod Update. 2012;18:313–32.

    CAS  PubMed  Google Scholar 

  4. Castellano JM, Bentsen AH, Sánchez-Garrido MA, Ruiz-Pino F, Romero M, Garcia-Galiano D, et al. Early metabolic programming of puberty onset: impact of changes in postnatal feeding and rearing conditions on the timing of puberty and development of the hypothalamic kisspeptin system. Endocrinology. 2011;152:3396–408.

    CAS  PubMed  Google Scholar 

  5. Quennell JH, Mulligan AC, Tups A, Liu X, Phipps SJ, Kemp CJ, et al. Leptin indirectly regulates gonadotropin-releasing hormone neuronal functio. Endocrinology. 2009;150:2805–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Quennell JH, Howell CS, Roa J, Augustine RA, Grattan DR, Anderson GM. Leptin deficiency and diet-induced obesity reduce hypothalamic kisspeptin expression in mice. Endocrinology. 2011;152:1541–50.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Moschos S, Chan JL, Mantzoros CS. Leptin and reproduction: a review. Fertil Steril. 2002;77:433–44.

    PubMed  Google Scholar 

  8. Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017;107:840–7.

    PubMed  Google Scholar 

  9. Tortoriello DV, McMinn JE, Chua SC. Increased expression of hypothalamic leptin receptor and adiponectin accompany resistance to dietary-induced obesity and infertility in female C57BL/6J mice. Int J Obes. 2007;31:395–402.

    CAS  Google Scholar 

  10. Agarwal SK, Vogel K, Weitsman SR, Magoffin DA. Leptin antagonizes the insulin-like growth factor-I augmentation of steroidogenesis in granulosa and theca cells of the human ovary. J Clin Endocrinol Metab. 1999;84:1072–6.

    CAS  PubMed  Google Scholar 

  11. Duggal PS, Van Der Hoek KH, Milner CR, Ryan NK, Armstrong DT, Magoffin DA, et al. The in vivo and in vitro effects of exogenous leptin on ovulation in the rat. Endocrinology. 2000;141:1971–6.

    CAS  PubMed  Google Scholar 

  12. Bruning JC, Gautam D, Burks DJ, Gillette J, Schubert M, Orban PC, et al. Role of brain insulin receptor in control of body weight and reproduction. Science. 2000;289:2122–5.

    CAS  PubMed  Google Scholar 

  13. van Leckwyck M, Kong W, Burton KJ, Amati F, Vionnet N, Pralong FP. Decreasing insulin sensitivity in women induces alterations in LH pulsatility. J Clin Endocrinol Metab. 2016;101:3240–9.

    PubMed  Google Scholar 

  14. Jain A, Polotsky AJ, Rochester D, Berga SL, Loucks T, Zeitlian G, et al. Pulsatile luteinizing hormone amplitude and progesterone metabolite excretion are reduced in obese women. J Clin Endocrinol Metab. 2007;92:2468–73.

    CAS  PubMed  Google Scholar 

  15. Quinkler M, Sinha B, Tomlinson JW, Bujalska IJ, Stewart PM, Arlt W. Androgen generation in adipose tissue in women with simple obesity--a site-specific role for 17beta-hydroxysteroid dehydrogenase type 5. J Endocrinol. 2004;183:331–42.

    CAS  PubMed  Google Scholar 

  16. Santoro N, Torrens J, Crawford S, Allsworth JE, Finkelstein JS, Gold EB, et al. Correlates of circulating androgens in mid-life women: the study of women’s health across the nation. J Clin Endocrinol Metab. 2005;90:4836–45.

    CAS  PubMed  Google Scholar 

  17. McCartney CR, Blank SK, Prendergast KA, Chhabra S, Eagleson CA, Helm KD, et al. Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls. J Clin Endocrinol Metab. 2007;92:430–6.

    CAS  PubMed  Google Scholar 

  18. Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord. 2002;26:883–96.

    CAS  PubMed  Google Scholar 

  19. Norman RJ, Clark AM. Obesity and reproductive disorders: a review. Reprod Fertil Dev. 1998;10:55–63.

    CAS  PubMed  Google Scholar 

  20. Pasquali R, Gambineri A. Metabolic effects of obesity on reproduction. Reprod Biomed Online. 2006;12:542–51.

    CAS  PubMed  Google Scholar 

  21. Matthaei S, Stumvoll M, Kellerer M, Häring HU. Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev. 2000;21:585–618.

    CAS  PubMed  Google Scholar 

  22. Poretsky L, Cataldo NA, Rosenwaks Z, Giudice LC. The insulin-related ovarian regulatory system in health and disease. Endocr Rev. 1999;20:535–82.

    CAS  PubMed  Google Scholar 

  23. Toprak S, Yönem A, Cakir B, Güler S, Azal O, Ozata M, et al. Insulin resistance in nonobese patients with polycystic ovary syndrome. Horm Res. 2001;55:65–70.

    CAS  PubMed  Google Scholar 

  24. Højlund K. Metabolism and insulin signaling in common metabolic disorders and inherited insulin resistance. Dan Med J. 2014;61:B4890.

    PubMed  Google Scholar 

  25. De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F. Genetic, hormonal and metabolic aspects of PCOS: an update. Reprod Biol Endocrinol. 2016;14:38.

    PubMed  PubMed Central  Google Scholar 

  26. El Hayek S, Bitar L, Hamdar LH, Mirza FG, Daoud G. Poly cystic ovarian syndrome: an updated overview. Front Physiol. 2016;7:124.

    PubMed  PubMed Central  Google Scholar 

  27. Piouka A, Farmakiotis D, Katsikis I, Macut D, Gerou S, Panidis D. Anti-Mullerian hormone levels reflect severity of PCOS but are negatively influenced by obesity: relationship with increased luteinizing hormone levels. Am J Physiol Endocrinol Metab. 2009;296:E238–43.

    CAS  PubMed  Google Scholar 

  28. Liu N, Ma Y, Wang S, Zhang X, Zhang Q, Zhang X, et al. Association of the genetic variants of luteinizing hormone, luteinizing hormone receptor and polycystic ovary syndrome. Reprod Biol Endocrinol. 2012;10:36.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Cadagan D, Khan R, Amer S. Thecal cell sensitivity to luteinizing hormone and insulin in polycystic ovarian syndrome. Reprod Biol. 2016;16:53–60.

    PubMed  Google Scholar 

  30. Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Hum Reprod Update. 2011;17:17–33.

    PubMed  Google Scholar 

  31. Slowinska-Srzednicka J, Zgliczynski W, Makowska A, Jeske W, Brezinska A, Saszynski P, et al. An abnormality of the growth hormone=insulin-like growth factor-1 axis in women with polycystic ovary syndrome due to coexistent obesity. J Clin Endocrinol Metab. 1992;74:1432–5.

    CAS  PubMed  Google Scholar 

  32. Veldhuis JD, Iranmanesh A, Ho KKY, Waters MJ, Johnson ML, Lizarralde G. Dual defects in pulsatile growth hormone secretion and clearance subserve the hyposomatotropinism of obesity in man. J Clin Endocrinol Metab. 1991;72:51–59.

    CAS  PubMed  Google Scholar 

  33. Berryman DE, Gla CA, List EO, Johannsson G. The GH/IGF-1 axis in obesity: pathophysiology and therapeutic considerations. Nat Rev Endocrinol. 2013;9:346–56.

    CAS  PubMed  Google Scholar 

  34. Vijayakumar A, Yakar S, LeRoith D. The intricate role of growth hormone inmetabolism. Front Endocrinol. 2011;2:1–11.

    Google Scholar 

  35. Juul A. Serum levels of insulin-like growth factor I and its binding proteins in health and disease. Growth Hormon. IGF Res. 2003;13:113–70.

    CAS  Google Scholar 

  36. Frystyk J, Brick DJ, Gerweck AV, Utz AL, Miller LL. Bioactive insulin-like growth factor- I in obesity. J Clin Endocrinol Metab. 2009;94:3093–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Savastano S, Di Somma C, Barrea L, Colao A. The complex relationship between obesity and the somatropic axis: the long and winding road. Growth Horm IGF Res. 2014;24:221–6.

    CAS  PubMed  Google Scholar 

  38. Hull KL, Harvey S. Growth hormone: roles in female reproduction. J Endocrinol. 2001;168:1–23.

    CAS  PubMed  Google Scholar 

  39. Jungheim ES, Schoeller EL, Marquard KL, Louden ED, Schaffer JE, Moley KH. Diet-induced obesity model: abnormal oocytes and persistent growth abnormalities in the offspring. Endocrinology. 2010;151:4039–46.

    CAS  PubMed  PubMed Central  Google Scholar 

  40. Luzzo KM, Wang Q, Purcell SH, Chi M, Jimenez PT, Grindler N, et al. High fat diet induced developmental defects in the mouse: oocyte meiotic aneuploidy and fetal growth retardation/brain defects. PLoS ONE. 2012;7:e49217.

    CAS  PubMed  PubMed Central  Google Scholar 

  41. Machtinger R, Combelles CMH, Missmer SA, Correia KF, Fox JH, Racowsky C. The association between severe obesity and characteristics of failed fertilized oocytes. Human Reproduction. 2012;27:3198–207.

    CAS  PubMed  Google Scholar 

  42. Cummins JM. The role of mitochondria in the establishment of oocyte functional competence. Eur J Obstet Gynecol Reprod Biol. 2004;115:S23–S29.

    CAS  PubMed  Google Scholar 

  43. Dumollard R, Duchen M, Carroll J. The role of mitochondrial function in the oocyte and embryo. Curr Top Dev Biol. 2007;77:21–49.

    CAS  PubMed  Google Scholar 

  44. Torner H, Brüssow KP, Alm H, Ratky J, Pöhland R, Tuchscherer A, et al. Mitochondrial aggregation patterns and activity in porcine oocytes and apoptosis in surrounding cumulus cells depends on the stage of pre-ovulatory maturation. Theriogenology. 2004;61:1675–89.

    CAS  PubMed  Google Scholar 

  45. Igosheva N, Abramov AY, Poston L, Eckert JJ, Fleming TP, Duchen MR, et al. Maternal diet-induced obesity alters mitochondrial activity and redox status in mouse oocytes and zygotes. PLoS ONE. 2010;5:e10074.

    PubMed  PubMed Central  Google Scholar 

  46. Wu LL, Dunning KR, Yang X, Russell DL, Lane M, Norman RJ, et al. High-fat diet causes lipotoxicity responses in cumulus-oocyte complexes and decreased fertilization rates. Endocrinology. 2010;151:5438–45.

    CAS  PubMed  Google Scholar 

  47. Jungheim ES, Travieso JL, Carson KR, Moley KH. Obesity and reproductive function. Obstet Gynecology Clin North Am. 2012;39:479–93.

    Google Scholar 

  48. Wu LL, Norman RJ, Robker RL. The impact of obesity on oocytes: evidence for lipotoxicity mechanisms. Reprod Fertil Dev. 2011;24:29–34.

    CAS  PubMed  Google Scholar 

  49. Broughton DE, Jungheim ES. A focused look at obesity and the preimplantation trophoblast. Semin Reprod Med. 2016;34:5–10.

    PubMed  Google Scholar 

  50. Jungheim ES, Macones GA, Odem RR, Patterson BW, Lanzendorf SE, Ratts VS, et al. Associations between free fatty acids, cumulus oocyte complex morphology and ovarian function during in vitro fertilization. Fertil Steril. 2011;95:1970–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  51. Rhee JS, Saben JL, Mayer AL, Schulte MB, Asghar Z, Stephens C, et al. Diet-induced obesity impairs endometrial stromal cell decidualization: a potential role for impaired autophagy. Hum Reprod. 2016;31:1315–26.

    CAS  PubMed  PubMed Central  Google Scholar 

  52. Hill MJ, Uyehara CFT, Hashiro GM, Frattarelli JL. The utility of serum leptin and follicular fluid leptin, estradiol and progesterone levels during an in vitro fertilization cycle. J Assist Reprod Genet. 2007;24:183–8.

    PubMed  PubMed Central  Google Scholar 

  53. Palomba S, de Wilde M, Falbo A, Koster MPH, La Sala GB. and Fauseet BCJM. Pregnancy complications in women with polycystic ovary syndrome. Human Reprod Update. 2015;21:575–92.

    Google Scholar 

  54. Metwally M, Preece R, Thomas J, Ledger W, Chiu LiT. A proteomic analysis of the endometrium in obese and overweight women with recurrent miscarriage: preliminary evidence for an endometrial defect. Reprod Biol Endocrinol. 2014;12:75.

    PubMed  PubMed Central  Google Scholar 

  55. Qiu Q, Yang M, Tsang BK, Gruslin A. Both mitogen-activated protein kinase and phosphatidylinositol 3-kinase signalling are required in epidermal growth factor-induced human trophoblast migration. Mol Human Reprod. 2004;10:677–84.

    CAS  Google Scholar 

  56. Tamer Erel C, Senturk LM. The impact of body mass index on assisted reproduction. Curr Opin Obstet Gynecol. 2009;21:228–35.

    PubMed  Google Scholar 

  57. Carrington B, Sacks G, Regan L. Recurrent miscarriage: pathophysiology and outcome. Curr Opin Obstet Gynecol. 2005;17:591–7.

    PubMed  Google Scholar 

  58. Tanaka T, Umesaki N. Leptin regulates the proliferation and apoptosis of human endometrial epithelial cells. Int J Mol Med. 2008;22:683–9.

    CAS  PubMed  Google Scholar 

  59. Winter E, Wang J, Davies MJ, Norman R. Early pregnancy loss following assisted reproductive technology treatment. Hum Reprod. 2002;17:3220–3.

    PubMed  Google Scholar 

  60. Styne-Gross A, Elkind-Hirsch K, Scott RT Jr. Obesity does not impact implantation rates or pregnancy outcome in women attempting conception through oocyte donation. Fertil Seril. 2005;83:1629–34.

    Google Scholar 

  61. Dechaud H, Anahory T, Reyftmann L, Loup V, Hamamah S, Hedon B. Obesity does not adversely affect results in patients who are undergoing in vitro fertilization and embryo transfer. Eur J Obstet Gynecol Reprod Biol. 2006;127:88–93.

    PubMed  Google Scholar 

  62. Matalliotakis I, Cakmak H, Sakkas D, Mahutte N, Koumantakis G, Arici A. Impact of body mass index on IVF and ICSI outcome: a retrospective study. Reprod Biomed Online. 2008;16:778–83.

    PubMed  Google Scholar 

  63. Banker M, Sorathiya D, Shah S. Effect of body mass index on the outcome of in-vitro fertilization/intracytoplasmic sperm injection in women. J Hum Repro Sci. 2017;10:37–43.

    Google Scholar 

  64. Kumbak B, Oral E, Bukulmez O. Female obesity and assisted reproductive technologies. Semin Reprod Med. 2012;3:507–16.

    Google Scholar 

  65. Luke B, Brown MB, Stern JE, Missmer SA, Fujimoto VY, Leach R, SART Writing Group. Female obesity adversely affects assisted reproductive technology (ART) pregnancy and live birth rates. Hum Reprod. 2011;26:245–52.

    PubMed  Google Scholar 

  66. Luke B, Brown MB, Missmer SA, Bukulmez O, Leach R, Stern JE, et al. The effect of increasing obesity on the response to and outcome of assisted reproductive technology: a national study. Hum Reprod. 2011;96:820–5.

    Google Scholar 

  67. Rittemberg V, Seshadri S, Sunkara SK, Sobaleva S, Oteng-Ntim E, El-Toukhy T. Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis. Reprod Biomed Online. 2011;23:421–39.

    Google Scholar 

  68. Fedorcsak P, Dale PO, Storeng R, Tanbo T, Abyholm T. The impact of obesity and insulin resistance on the outcome of IVF or ICSI in women with polycystic ovarian syndrome. Human Reprod. 2001;16:1086–91.

    CAS  Google Scholar 

  69. Ertzeid G, Storeng R. Adverse effects of gonadotropin treatment on pre- and postimplantation development in mice. J Reprod Fertility. 1992;96:649–55.

    CAS  Google Scholar 

  70. Ertzeid G, Storeng R, Lyberg T. Treatment with gonadotropins impaired implantation and fetal development in mice. J Assis Reprod Genet. 1993;10:286–91.

    CAS  Google Scholar 

  71. Becker GF, Passos EP, Moulin CC. Short-term effects of a hypocaloric diet with low glycemic index and low glycemic load on body adiposity, metabolic variables, ghrelin, leptin, and pregnancy rate in overweight and obese infertile women: a randomized controlled trial. Am J Clin Nutr. 2015;102:1365–72.

    CAS  PubMed  Google Scholar 

  72. Sim KA, Dezarnaulds GM, Denyer GS, Skilton MR, Caterson ID. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 2014;4:61–8.

    CAS  PubMed  Google Scholar 

  73. Public Affairs Committee of the Teratology Society. Teratology Public Affairs Committee position paper: maternal obesity and pregnancy. Birth Defect Res. 2006;76:73–7.

    Google Scholar 

  74. Kabiru W, Raynor D. Obstetric outcome associated with increase in BMI category during pregnancy. Am. J Obstet Gynaecol. 2004;191:928–32.

    Google Scholar 

  75. Linne‘ Y. Effects of obesity on women’s reproduction and complications during pregnancy. Obes Rev. 2004;5:137–43.

    Google Scholar 

  76. Hall F, Neubert A. Obesity and pregnancy. Obstet Gynaecol Sur. 2005;4:253J–60J.

    Google Scholar 

  77. Kabiru W, Raynor D. Obstetric outcome associated with increase in BMI category during pregnancy. Am J Obstet Gynaecol. 2004;191:928–32.

    Google Scholar 

  78. Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Human Reprod. 1998;13:1502–5.

    CAS  Google Scholar 

  79. Sim KA, Dezarnaulds GM, Denyer GS, Skilton MR, Caterson ID. Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial. Clin Obes. 2014;4:61–8.

    CAS  PubMed  Google Scholar 

  80. Musella M, Milone M, Bellini M, Sosa Fernandez ME, Sosa Fernandez LM, Leongito M, et al. The potential role of intragastric balloon in the treatment of obese-related infertility: personal experience. Obes Surg. 2011;21:426–30.

    PubMed  Google Scholar 

  81. Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.

    PubMed  Google Scholar 

  82. Rothberg A, Lanham M, Randolph J, Fowler C, Miller N, Smith Y. The feasibility of a brief, intensive weight loss intervention to improve reproductive outcomes in obese, subfertile women: a pilot study. Fertil Steril. 2016;106:1212–20.

    PubMed  PubMed Central  Google Scholar 

  83. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223–36.

    CAS  PubMed  Google Scholar 

  84. Pasquali R, Gambineri A, Pagotto U. The impact of obesity on reproduction in women with polycystic ovary syndrome. Br J Obstet Gynecol. 2006;113:1148–59.

    CAS  Google Scholar 

  85. Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ, West C, et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Human Reproduction. 1995;10:2107–11.

    CAS  PubMed  Google Scholar 

  86. Pasquali R, Patton L, Gambineri A. Obesity and infertility. Curr Opin Endocrinol Diabetes Obes. 2007;14:482–7.

    PubMed  Google Scholar 

  87. Jungheim ES, Lanzendorf SE, Odem RR, Moley KH, Chang AS, Ratts VS. Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome. Fertil Steril. 2009;92:256–61.

    PubMed  Google Scholar 

  88. Pasquali R, Gambineri A. PCOS: a multifaceted disease from adolescence to adult age. Ann NY Acad Sci. 2006;1092:158–74.

    PubMed  Google Scholar 

  89. Barber TM, McCarthy MI, Wass JAH, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol. 2006;65:137–45.

    CAS  Google Scholar 

  90. Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril. 2009;921:966–82.

    Google Scholar 

  91. Moran LJ, Hutchison SK, Norman RJ, Teede HJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2011;7:CD007506.

    Google Scholar 

  92. Kiddy DS, Hamilton-Fairley D, Bush A, Short F, Anyaoku V, Reed MJ, et al. Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clin Endocrinol. 1992;36:105–11.

    CAS  Google Scholar 

  93. Crosignani PG, Colombo M, Vegetti W, Somigliana E, Gessati A, Ragni G. Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet. Human Reprod. 2003;18:1928–32.

    Google Scholar 

  94. Pasquali R, Gambineri A, Cavazza C, Ibarra Gasparini D, Ciampaglia W, Cognigni GE, et al. Heterogeneity in the responsiveness to long-term lifestyle intervention and predictability in obese women with polycystic ovary syndrome. Eur J Endocrinol. 2011;164:53–60.

    CAS  PubMed  Google Scholar 

  95. Skubleny D, Switzer NJ, Gill RS, Dykstra M, Shi X, Sagle MA, et al. The impact of bariatric surgery on polycystic ovary syndrome: a systematic review and meta-analysis. Obes Surg. 2016;26:169–76.

    PubMed  Google Scholar 

Download references

Acknowledgements

Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group members served as collaborators and approved the final version of the manuscript: Annamaria Colao, Antonio Aversa, Barbara Altieri, Luigi Angrisani, Giuseppe Annunziata, Rocco Barazzoni, Luigi Barrea, Giuseppe Bellastella, Bernadette Biondi, Elena Cantone, Brunella Capaldo, Sara Cassarano, Rosario Cuomo, Luigi Di Luigi, Andrea Di Nisio, Carla Di Somma, Ludovico Docimo, Katherine Esposito, Carlo Foresta, Pietro Forestieri, Alessandra Gambineri, Francesco Garifalos, Cristiano Giardiello, Carla Giordano, Francesco Giorgino, Dario Giugliano, Daniela Laudisio, Davide Lauro, Andrea Lenzi, Silvia Magno, Paolo Macchia, MariaIda Maiorino, Emilio Manno, Chiara Marocco, Paolo Marzullo, Chiara Mele, Davide Menafra, Silvia Migliaccio, Marcello Monda, Filomena Morisco, Fabrizio Muratori, Giovanna Muscogiuri, Mario Musella, Gerardo Nardone, Claudia Oriolo, Uberto Pagotto, Pasquale Perrone Filardi, Luigi Piazza, Rosario Pivonello, Barbara Polese, Paolo Pozzilli, Giulia Puliani, Stefano Radellini, Gabriele Riccardi, Domenico Salvatore, Ferruccio Santini, Giovanni Sarnelli, Lorenzo Scappaticcio, Silvia Savastano, Bruno Trimarco, Dario Tuccinardi, Paola Vairano, Nunzia Verde, Roberto Vettor.

Funding

This article is published as part of a supplement funded by Endocrinology Unit, Department of Clinical Medicine and Surgery, University Federico II, Naples, Italy.

Author information

Authors and Affiliations

  1. Endocrinology Unit, Department of Medical and Surgical Sciences, Centre for Applied Biomedical Research (C.R.B.A.), S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Alessandra Gambineri

  2. Endocrinology Unit, Department of Medical and Surgical Sciences, Federico II University Medical School of Naples, Naples, Italy

    Daniela Laudisio, Annamaria Colao & Silvia Savastano

  3. Department of Movement, Human and Health Sciences, University of Rome ‘Foro Italico’, Rome, Italy

    Chiara Marocco

  4. Endocrinology and Metabolic Diseases Unit, Biomedical Department of Internal and Specialist Medicine (DIBIMIS), University of Palermo, Palermo, Italy

    Stefano Radellini

Authors
  1. Alessandra Gambineri
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Laudisio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Marocco
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stefano Radellini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Annamaria Colao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Silvia Savastano
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

on behalf of the Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group

Contributions

The author’s responsibilities were as follows: AG, DL, CM, and SR were responsible for the concept of this paper and drafted the manuscript; AG, SS, and AC provided a critical review of the paper.

Corresponding author

Correspondence to Alessandra Gambineri.

Ethics declarations

Conflict of interest

AG is a consultant for Bayer. The remaining authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Members of the Obesity Programs of nutrition, Education, Research and Assessment (OPERA) group are listed below Acknowledgements.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gambineri, A., Laudisio, D., Marocco, C. et al. Female infertility: which role for obesity?. Int J Obes Supp 9, 65–72 (2019). https://doi.org/10.1038/s41367-019-0009-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41367-019-0009-1

This article is cited by

Search

Advanced search

Quick links