Obesity, insulin resistance and fertility: unresolved questions and emerging insights.

IF 2.6 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Current Opinion in Endocrinology & Diabetes and Obesity Pub Date : 2025-06-01 Epub Date: 2025-03-24 DOI:10.1097/MED.0000000000000907

Kavita Narula, Julia S Kenkre, Wann Jia Loh, Tricia Tan

{"title":"Obesity, insulin resistance and fertility: unresolved questions and emerging insights.","authors":"Kavita Narula, Julia S Kenkre, Wann Jia Loh, Tricia Tan","doi":"10.1097/MED.0000000000000907","DOIUrl":null,"url":null,"abstract":"Purpose of review: Obesity significantly impacts fertility in women, contributing to hormonal imbalances, ovulatory dysfunction, and poor reproductive outcomes. This is especially pronounced in polycystic ovary syndrome (PCOS), where obesity and insulin resistance exacerbate fertility challenges. Moreover, obesity is a risk factor for type 2 diabetes (T2D) and gestational diabetes (GDM), further complicating reproductive health. Effective weight loss interventions before conception are essential to improve fertility and reduce the risks of adverse perinatal outcomes, such as GDM, hypertensive disorders, and neonatal complications.Recent findings: Lifestyle modifications, including modest calorie restriction and exercise, improve ovulatory function and pregnancy rates but have limited impact on live-birth rates during fertility treatments. Very low-calorie diets (VLCDs) achieve rapid weight loss but raise concerns about maternal nutrition. Pharmacotherapy offers modest benefits for weight loss and fertility, though teratogenic risks persist. Bariatric surgery often results in significant weight loss and enhanced fertility, yet requires careful timing and management of potential nutrient deficiencies.Summary: Weight-loss interventions show promise in addressing obesity-related fertility issues, but long-term outcomes and optimal strategies remain unclear. Further research is needed to bridge these gaps and improve reproductive outcomes following weight reduction.","PeriodicalId":10964,"journal":{"name":"Current Opinion in Endocrinology & Diabetes and Obesity","volume":" ","pages":"108-114"},"PeriodicalIF":2.6000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Endocrinology & Diabetes and Obesity","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MED.0000000000000907","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/24 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose of review: Obesity significantly impacts fertility in women, contributing to hormonal imbalances, ovulatory dysfunction, and poor reproductive outcomes. This is especially pronounced in polycystic ovary syndrome (PCOS), where obesity and insulin resistance exacerbate fertility challenges. Moreover, obesity is a risk factor for type 2 diabetes (T2D) and gestational diabetes (GDM), further complicating reproductive health. Effective weight loss interventions before conception are essential to improve fertility and reduce the risks of adverse perinatal outcomes, such as GDM, hypertensive disorders, and neonatal complications.

Recent findings: Lifestyle modifications, including modest calorie restriction and exercise, improve ovulatory function and pregnancy rates but have limited impact on live-birth rates during fertility treatments. Very low-calorie diets (VLCDs) achieve rapid weight loss but raise concerns about maternal nutrition. Pharmacotherapy offers modest benefits for weight loss and fertility, though teratogenic risks persist. Bariatric surgery often results in significant weight loss and enhanced fertility, yet requires careful timing and management of potential nutrient deficiencies.

Summary: Weight-loss interventions show promise in addressing obesity-related fertility issues, but long-term outcomes and optimal strategies remain unclear. Further research is needed to bridge these gaps and improve reproductive outcomes following weight reduction.

查看原文本刊更多论文

肥胖，胰岛素抵抗和生育：未解决的问题和新见解。

综述的目的：肥胖显著影响女性的生育能力，导致激素失衡、排卵功能障碍和不良的生殖结果。这在多囊卵巢综合征（PCOS）中尤其明显，肥胖和胰岛素抵抗加剧了生育挑战。此外，肥胖是2型糖尿病（T2D）和妊娠糖尿病（GDM）的危险因素，进一步使生殖健康复杂化。孕前有效的减肥干预措施对于提高生育能力和降低不良围产期结局（如妊娠糖尿病、高血压疾病和新生儿并发症）的风险至关重要。最近的研究发现：生活方式的改变，包括适度的卡路里限制和锻炼，可以改善排卵功能和怀孕率，但对生育治疗期间的活产率影响有限。极低热量饮食（vlcd）可以快速减轻体重，但也引起了对孕产妇营养的担忧。药物治疗对减肥和生育有一定的好处，但致畸风险仍然存在。减肥手术通常会导致显著的体重减轻和生育能力的提高，但需要仔细选择时机和管理潜在的营养缺乏。摘要：减肥干预措施有望解决与肥胖相关的生育问题，但长期结果和最佳策略尚不清楚。需要进一步的研究来弥补这些差距，并改善体重减轻后的生殖结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Current Opinion in Endocrinology & Diabetes and Obesity ENDOCRINOLOGY & METABOLISM-

CiteScore

5.80

自引率

3.10%

发文量

128

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Endocrinology, Diabetes and Obesity delivers a broad-based perspective on the most recent and exciting developments in the field from across the world. Published bimonthly and featuring twelve key topics – including androgens, gastrointestinal hormones, diabetes and the endocrine pancreas, and neuroendocrinology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.